Sodium Transfer From Plasma to CSF in Severe Depressive Illness

Abstract

ABNORMALITIES of water and electrolyte metabolism in depressive illness have been reported many times. The subject has been recently reviewed by Coppen¹ who considers that an increase in intracellular sodium and a low intracellular potassium content are features of the depressed state, the sodium abnormality being reversible. One of the findings in this field is the report² that depressed patients have an abnormality of the blood-brain-cerebrospinal fluid (CSF) barrier resulting in subnormal transfer rates of sodium from plasma to cerebrospinal fluid. Since this report, like much of the recent work in the subject, has never been confirmed, we have undertaken a similar study in severely depressed patients. Subjects and Methods Eleven patients admitted to the Professorial Psychiatric Unit with a primary depressive illness were studied. They were typical melancholic patients diagnosed as psychotic endogenous depressives with the clinical features of agitation,