Skip to main content
Log in

Lithium Revisited: Savings Brought About by the Use of Lithium, 1970–1991

  • Published:
Psychiatric Quarterly Aims and scope Submit manuscript

Abstract

Background: Recent estimates of the cost of manic-depressive illness totaled roughly $45 billion in 1991. Using data from the Epidemiological Catchment Area (ECA) study, this study estimates the savings brought about by the use of lithium between 1970 and 1991. Methods: Total savings are the difference between estimated actual costs and projected costs had lithium never been introduced. Actual yearly costs were interpolated from data for 1970 and 1991, and projected costs were obtained by adjusting 1970 costs with Consumer Price Index (CPI) and population inflaters. All costs for 1970 were obtained using methods almost identical to those used to calculate the 1991 costs of manic-depressive illness, presented in a previous publication. All savings are presented in 1991 dollars. Results: Between 1970 and 1991, lithium saved over $170 billion, or roughly over $8 billion per year. Approximately $15 billion in direct costs, which included inpatient and outpatient care as well as research, was saved between 1970 and 1991. The savings are more dramatic for indirect costs, which include the lost productivity of wage-earners, homemakers, family caregivers, and individuals who are in institutions or who committed suicide; these totaled roughly $155 billion. Conclusions: Our results suggest that, although manic-depressive illness is still costly, lithium has been tremendously successful in treating the illness, and has provided enormous financial savings in the process.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  1. Weissman MM, Bruce ML, Leaf PJ, et al: Affective disorders, in Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. Edited by Robins LN, Regier DA. New York, The Free Press, 1991.

    Google Scholar 

  2. Reifman A, Wyatt RJ: Lithium: A brake in the rising cost of mental illness. Archives of General Psychiatry 37:385–388, 1980.

    Google Scholar 

  3. Robins LN, Regier DA: Psychiatric Disorders in America: The Epidemiologic Catchment Area Study. New York, The Free Press, 1991.

    Google Scholar 

  4. Wyatt RJ, Henter I: An economic evaluation of manic-depressive illness-1991. Social Psychiatry and Psychiatric Epidemiology 30:213–219, 1995.

    Google Scholar 

  5. U.S. Bureau of the Census: Statistical Abstract of the United States:1991, 111th ed. Washington, DC, 1991.

  6. IMS: Lithium market total prescriptions 1975-1997. IMS America, 1998.

  7. U.S. Department of Labor: Consumer price index. Bureau of Labor Statistics, 1992.

  8. Gelenberg AJ, Hopkins HS: Report on efficacy of treatments for bipolar disorder. Psychopharmacology Bulletin 29:447–456, 1993.

    Google Scholar 

  9. Goodwin FK, Murphy DL, Bunney WF: Lithium carbonate treatment in depression and mania:Alongitudinal double-blind study. Archives of General Psychiatry 21:486–496, 1969.

    Google Scholar 

  10. Schou M, Juel-Nielson N, Stromgren E, et al: The treatment of manic psychoses by administration of lithium salts. Journal of Neurology, Neurosurgery, and Psychiatry 17:250–260, 1954.

    Google Scholar 

  11. Stokes PE, Shamoian CA, Stoll PM, et al: Efficacy of lithium as acute treatment of manic-depressive illness. The Lancet 1971:1319–1325, 1971.

    Google Scholar 

  12. American Psychiatric Association: Practice guideline for the treatment of patients with bipolar disorder. American Journal of Psychiatry 151(Suppl. 12):iii–36, 1994.

    Google Scholar 

  13. Greenberg PE, Stiglin LE, Finkelstein SN, et al: The economic burden of depression in 1990. Journal of Clinical Pyschiatry 54(11):405–418, 1993.

    Google Scholar 

  14. Gurland BJ, Fleiss JL, Cooper JE, et al: Cross-national study of diagnosis of the mental disorders: Some comparisons of diagnostic criteria from the first investigation. American Journal of Psychiatry 125(10, April Suppl.):30–39, 1969.

    Google Scholar 

  15. Baldessarini RJ: Frequency of diagnoses of schizophrenia versus affective disorders from 1944 to 1968. American Journal of Psychiatry 127(6):59–63, 1970.

    Google Scholar 

  16. Rosenheck R, Frisman LK, Lister C: Hospital administrative costs (letter). New England Journal of Medicine 329:1655, 1993.

    Google Scholar 

  17. Taube CA, Barrett SA: Mental Health, United States 1983. Bethesda, National Institute of Mental Health, Superintendent of Documents, Government Printing Office, 1984.

    Google Scholar 

  18. Stoudemire A, Frank R, Hedemark N: The economic burden of depression. General Hospital Psychiatry 8(6):389–394, 1986.

    Google Scholar 

  19. Narrow WE, Regier DA, Rae DS, et al: Use of services by persons with mental and addictive disorders. Findings from the National Institute of Mental Health Epidemiological Catchment Area Program. Archives of General Psychiatry 50(2):95–107, 1993.

    Google Scholar 

  20. Simon GE, Unutzer J: Health care utilization and costs among patients treated for bipolar disorder in an insured population. Psychiatric Services 50: 1303–1308, 1999.

    Google Scholar 

  21. Segal J: Research in the service of mental health: Report of the Research Task Force of the National Institute of Mental Health. Rockville, MD, National Institute of Mental Health, 1975.

    Google Scholar 

  22. Tondo L, Jamison KR, Baldessarini RJ: Effect of lithium maintenance on suicidal behavior in major mood disorders, in The Neurobiology of Suicide: From the Bench to the Clinic, vol. 836. Edited by Stoff DM, Mann JJ. New York, The New York Academy of Sciences, 1997.

    Google Scholar 

  23. Muller-Oerlinghausen B, Ahrens B, Vok J, et al: Letter-Reduced mortality of manicdepressive patients in long-term lithium treatment: An international collaborative study by IGSLI. Psychiatry Research 36:329–331, 1991.

    Google Scholar 

  24. Muller-Oerlinghausen B, Muser-Causemann B, Volk J: Suicides and parasuicides in a high-risk group on and off lithium long-term medication. Journal of Affective Disorders 25(4):261–269, 1992.

    Google Scholar 

  25. Vestergaard P, Aagaard J: Five-year mortality in lithium-treated manic-depressive patients. Journal of Affective Disorders 21:33–38, 1991.

    Google Scholar 

  26. Page C, Benaim S, Lappin F: A long-term retrospective follow-up study of patients treated with prophylactic lithium carbonate. British Journal of Psychiatry 150:175–179, 1987.

    Google Scholar 

  27. Weeke A: Causes of death in manic-depressives, in Origin, Prevention and Treatment of Affective Disorders. Edited by Schou M, Stromgren E. London, Academic Press, 1979.

    Google Scholar 

  28. Goodwin FK, Jamison KR: Manic-Depressive Illness. New York, Oxford University Press, 1990.

    Google Scholar 

  29. Coppen A, Standish-Barry H, Bailey J, et al: Does lithium reduce the mortality of recurrent mood disorders? Journal of Affective Disorders 23(1):1–7, 1991.

    Google Scholar 

  30. Franks DD: Economic contribution of families caring for persons with severe and persistent mental illness. Administration and Policy in Mental Health 18:918, 1990.

    Google Scholar 

  31. Perlick D, Clarkin JF, Sirey J, et al: Burden experienced by care-givers of persons with bipolar affective disorder. British Journal of Psychiatry 175:56–62, 1999.

    Google Scholar 

  32. Manderscheid RW, Sonnenschein MA: Mental Health, United States, 1990. National Institute of Mental Health, Superintendent of Documents, U.S. Government Printing Office, 1990.

  33. Walden J, Normann C, Langosch J, et al: Differential treatment of bipolar disorder with old and new antiepileptic drugs. Neuropsychobiology 38:181–184, 1998.

    Google Scholar 

  34. Calabrese JR, Fatemi SH, Kujawa M, et al: Predictors of response to mood stabilizers. Journal of Clinical Psychopharmacology 16(Suppl):24S–31S, 1996.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wyatt, R.J., Henter, I.D. & Jamison, J.C. Lithium Revisited: Savings Brought About by the Use of Lithium, 1970–1991. Psychiatr Q 72, 149–166 (2001). https://doi.org/10.1023/A:1010319610021

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1010319610021

Navigation