Brain Energy Metabolism and Blood-Brain Barrier Permeability in Depressive Patients: Analyses of Creatine Creatinine, Urate, and Albumin in CSF and Blood

A reliable method is described to measure creatine, creatinine, & urate in human cerebrospinal fluid (CSF)& blood, using high pressure liquid chromatography; albumin was analyzed by routine methods. Analyses were performed on 41 male & 58 female inpatients with RDC major depressive disorders, with a mean age of about 40 years. CSF creatinine was negatively linked with suicidal ideation & increased appetite. The BBB tended to be the more permeable the less melancholic the depression. No measure appeared to be dependent on depressive state. Comparisons of depressive subgroups revealed a higher CSF creatinine concentration in sporadic unipolar patients according to Winokur. Pure unipolars with an impaired BBB were more suicidal. (36 refs)