Arginine vasopressin (AVP) neurons of the hypothalamo-neurohypophseal system (HNS) are innervated by numerous afferent pathways carrying information about two physiologically important parameters: blood volume/pressure and osmolality. These pathways use a variety of neurotransmitters/neuropeptides. In order to understand normal and pathological regulation of VP secretion, the mechanisms underlying integration of these complex afferent signals by the AVP neurons must be understood. The importance of neurotransmitter interactions in determining hormone release is highlighted by the finding that simultaneous exposure to adenosine triphosphate (ATP, a neurotransmitter acting on purinergic receptors) and phenylephrine (PE; to mimic norepinephrine activation of alpha1-adrenergic receptors) results in potentiation of AVP release that is characterized by an increase in the peak response and conversion of a transient response to a response that is sustained for hours. Evaluation of the mechanisms responsible for this response indicated that (1) activation of P2X purinergic receptors (P2X-R) is required, (2) protein kinase C (PKC) activation is required, (3) the sustained component requires new gene transcription, (4) the synergism does not involve presynaptic mechanisms nor does it occur directly in the neural lobe and (5) live-cell Ca(++) imaging techniques demonstrated a sustained increase in [Ca(++)](i) and that ATP activates P2Y-Rs as well as P2X-Rs in supraoptic neurons. Since the subtypes of P2X-Rs differ in their rate of desensitization, identification of the subtype of P2X-Rs participating in the initial and sustained responses to ATP+PE may elucidate mechanisms underlying the abrupt and transient responses to orthostatic hypotension versus sustained responses to chronic hypovolemia or vasodilation.