Adenosine 3'5' cyclic monophosphate metabolism in patients with severe depressive illness.

The daily excretion of adenosine 3'5' cyclic monophosphate (c-AMP) in a group of 19 patients with a severe depressive illness was found to be significantly decreased when compared with that from a group of euthymic patients being treated for other disorders in the same ward. The daily excretion of the depressed patients increased during the period of treatment and recovery from the illness. Treatment with a tricyclic antidepressant caused a greater increase than electroconvulsive treatment (ECT). There was no difference between the mean plasma c-AMP concentration of the depressed and euthymic groups. The mean CSF-c-AMP concentration was not different from the mean plasma c-AMP concentration in 12 patients with severe depression. There was no direct correlation between the CSF and plasma concentrations within patients. It was concluded that there may be a reversible disturbance in the renal metabolism of c-AMP in patients with severe depression.