Cerebrospinal fluid (CSF) was collected under controlled conditions from subjects suffering from major depression (n = 63) or schizophrenia (n = 28) and from healthy controls (n = 20). Following Sep-pak extraction, calcitonin gene-related peptide immunoreactivity (CGRP-LI) was determined by radioimmunoassay in sample aliquots. CGRP-LI concentrations in CSF were increased in the depressed patients compared to the schizophrenic and control subjects (P < 0.001). No CGRP-LI differences were found between the latter two groups. CGRP-LI did not correlate to any of the technical (e.g. storage conditions) or patient (demographic, biochemical, or clinical) variables investigated. In view of the CGRP's discrete distribution and specific effects in brain and the above results, we hypothesize that increased CSF CGRP-LI might be a trait marker of major depression. Regardless of the mechanisms (altered synthesis/release/metabolism in brain or changed fate in CSF) leading to elevated CSF CGRP-LI, the identification of a possible disease trait marker should contribute to the early diagnosis of major depression and identification of family members at risk and may help in differential diagnosis in other disorders with affective symptomatology.