Stimulation of SH-SY5Y human neuroblastoma cells with carbachol, a muscarinic agonist, down-regulates the type I inositol 1,4,5-trisphosphate (InsP3) receptor by > 90% with maximal and half-maximal effects after approximately 6 h and approximately 1 h, respectively. Examination of the mechanistic basis of this down-regulation revealed that carbachol increased the rate of type I InsP3 receptor degradation (radiolabeled immunoprecipitable receptor was lost from cells with half-times of > 8 h and approximately 1 h in the absence and presence of carbachol, respectively) and that the concentration of type I InsP3 receptor mRNA, despite a transient decrease after 3 h, did not correlate with levels of the receptor. Only those muscarinic receptor subtypes coupled to stimulation of phosphoinositide hydrolysis were capable of causing type I InsP3 receptor down-regulation. Ca2+ mobilization was pivotal to the mechanisms of receptor down-regulation, since perturbation of Ca2+ homeostasis with either EGTA or thapsigargin blocked the ability of carbachol to accelerate receptor degradation. Studies with thapsigargin also revealed that both functional InsP3-sensitive Ca2+ stores and persistent elevation of InsP3 concentration were required for down-regulation to occur. In conclusion, phosphoinositidase C-linked muscarinic receptors down-regulate the type I InsP3 receptor by accelerating its degradation. It appears that this process is initiated by persistent discharge of intracellular Ca2+ stores via the channels formed by tetramerically complexed type I InsP3 receptors.