Brain lithium concentrations were measured in eight patients with affective disorders using lithium-7 magnetic resonance spectroscopy (MRS). Brain lithium concentrations correlated better with serum concentrations (n = 23, r = 0.66, p < 0.001) than with erythrocyte concentrations (r = 0.44, p < 0.05). Because of previous data in animal experiments these results were unexpected, but the differences in cation transport mechanisms between neurons and erythrocytes may account for the results.