Evidence from in vitro and in vivo studies suggests that the therapeutic and prophylactic effects of lithium in recurrent affective disorders are due to an attenuation of the inositol-phospholipid (IPL) second messenger system. An increased sensitivity of this signal transduction system might therefore constitute a risk factor for affective illness. The extent of the agonist-induced release of intracellular Ca2+ (Ca2+ response) can be used as an indicator of the sensitivity of the IPL system. Using this paradigm, we have measured the agonist-induced Ca2+ response in neutrophils of 17 unmedicated patients who were experiencing an acute major depressive episode. The neutrophils were stimulated by the chemotactic peptide formylmethionylleucylphenylalanine, which activates the IPL system in the cells. The sensitivity of the IPL system in these patients was significantly greater (dose-response curve shifted to the left) compared with its sensitivity in healthy age- and sex-matched control subjects. The results indicate that acute episodes of major depression are associated with an increased sensitivity of the IPL system.