The successful treatment with lithium carbonate of two patients originally diagnosed as schizophrenic (paranoid subtype) and previously treated with electroshock treatment is described. The implications of treatment as related to diagnosis are discussed in a detailed retrospective analysis of the cases. It would seem that target symptoms have increasing importance with the dramatic development of neuropsychopharmacology. Two possible target symptoms, affective rage and hyperactivity, are discussed in their apparent relationship to the therapeutic efficacy of lithium carbonate in episodic forms of psychoses. Further differentiation of these symptom complexes is presented in terms of establishing more sophisticated criteria for the appropriate use of psychopharmacologic modalities in the future.