UThere is flO longer any real doubt that lithium carhonate has a preventive effect on recurrent manicdepressive psychoses. There have been well-controlled double-blind studies confirming a prophylactic effeet.”2 A study that involved 18 hospitals and 205 patients showed that lithium was significantly more effective than a placebo in preventing relapses.3 After those reports, there has been a gradual increase in the number of patients on long-term lithium treatment. With the present emphasis on cost-effectiveness, it is important to consider the economic aspects of lithium treatment. A program for the treatment and prevention of recurrent affective disorders began in 1968 at St. Vincent’s Hospital and Medical Center of New York.4 In the past eight years, considerable experience has been accumulated with more than 100 patients. The patients are treated in a specialized lithium clinic in a teaching hospital setting. The staff include a senior psychiatrist, rotating psychiatric residents, a clinical sociologist, and a nurse. The patients are given extensive psychiatric,