Hi Dennis,, Increased serum calcium is associated with depression, acute psychosis and dementia. How hypercalcemia causes depression is not well known. Functional MRI of brain in patients of depression with hypercalcemia showed changes in medial prefrontal and dorsolateral prefrontal cortex. In patient of hypercalcemia CSF showed decreased 5HIAA ,a metabolite of serotonin. Ex vivo study of human cell have showed decreased calcium induced modulation of 5HT3 receptor, although specific binding site yet to be defined in hypercalcemia.. Thanks