Discuss the three factors that slowed the acceptance of lithium in the United States.
What will be an ideal response?
First, there was an incident involving lithium chloride as a sodium chloride substitute for heart patients. Above a certain level, lithium is toxic and, because there was no dose limit, many users became ill and several died. Lithium then had a bad reputation as potentially lethal. Second, mania was not seen as a major problem in the United States. The behavior of mania is rarely the kind in which people would seek treatment. Patients who would become quite manic and lose touch with reality would have been called schizophrenic at that time, and antipsychotics are usually effective in controlling mania. The third reason deals with economics and the problem with drug introduction in the United States. A company that wants to sell a drug must spend a great deal of money to demonstrate safety and effectiveness to the FDA. Because lithium is one of the basic chemical elements and its simple salts had been available for many years, it would have been impossible to receive a patent making it easy for others to sell the drug after approval. Therefore, the company could not have recouped its research investment.
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