Cymbalta significantly reduced core anxiety symptoms and associated painful
physical symptoms and improved functional impairment associated with the
illness. Cymbalta is also approved for the
management of neuro-pathic pain associated with diabetic peripheral
neuropathy. "Facts About Generalized Anxiety
Disorder.nimh . "Anxiety Disorders.nmha.adaa. "All four
companies could stop making vaccines tomorrow without much impact on their
bottom lines," he writes.1 million - more than half of the entire
market for pertussis vaccine at the time. Offit,
liability costs have caused pharmaceutical companies to flee the vaccine
business.
The Vaccine Injury Compensation Program, which Congress authorized in 1986
to compensate families whose children were injured by vaccines, reduced some
financial pressure on vaccine manufacturers. One successful historical model, the March of Dimes, drew on a
private national foundation that funded research and large clinical trials,
and culminated in the eradication of polio in the United States.chop.

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"While it is important to evaluate anxiety symptoms such as excessive worry
and irritability, it is also important to evaluate associated painful
physical symptoms and functioning because many patients also report these
symptoms," said Christer Allgulander, MD, associate professor , senior
lecturer, Karolinska Institutet, and lead author on the study. In all clinical trials, most people were not bothered enough by
side effects to stop taking Cymbalta. However, says Dr. He also sits on the advisory board of the Global Alliance for
Vaccines and Immunization. He is the co-author of a book for parents,
"Vaccines: What You Should Know," now in its third edition.

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(average improvement 60mg = 51%,
120mg = 50%, sugar pill = 32%)

-- Greater response rates (58 %, 56%, 31%, respectively)

-- Greater sustained improvement rates (64%, 67%, 43%,
respectively)

-- Patients receiving Cymbalta 60mg/day and 120mg/day experienced greater
remission rates compared to those receiving sugar pill (31%, 38% and
19%, respectively) .(4) Episodes of
generalized anxiety disorder may be brought on, or worsened by, stressful
life events.

Patients on antidepressants and their families or caregivers should watch
for worsening depression symptoms, unusual changes in behavior and thoughts
of suicide, as well as for anxiety , agitation, panic attacks, difficulty
sleeping, irritability, hostility, aggressiveness, impulsivity ,
restlessness, or extreme hyperactivity., Lilly provides answers -- through
medicines and information -- for some of the world's most urgent medical
needs.D.

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Patients with a recent diagnosis (within six months) of major depression
were excluded from this study.com/.com. In contrast, markets for
cholesterol-lowering agents, hair loss products, potency drugs, or drugs for
heart disease or obesity are often $7 billion or more per drug. Dr.

Contact: Rachel Salis
Phone: (267) 426-6063
salis@email.edu

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A new study of approximately 500 patients evaluated
the safety and efficacy of the antidepressant Cymbalta (duloxetine HCl)
on the core anxiety symptoms in patients with generalized anxiety disorder.

For full Prescribing Information, including Boxed Warning, visit
http://www.lilly. However, as with any pharmaceutical product, there
are substantial risks and uncertainties in the process of development and
commercialization . There is no guarantee that the product will continue to
be commercially successful.
What is needed , he says, are social and political commitments to use that
technology to its best advantage. Offit
is a former member of the Advisory Committee on Immunization Practices, the
federal panel that provides vaccine advice to the Centers for Disease Control
and Prevention.
Through its longstanding commitment to providing exceptional patient care,
training new generations of pediatric healthcare professionals and pioneering
major research initiatives, Children's Hospital has fostered many discoveries
that have benefited children worldwide.chop.

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In this nine-week study, Cymbalta significantly improved core anxiety
symptoms such as anxious mood, fears and tension by 51 percent in patients
taking 60mg/day and by 50 percent in patients taking 120mg/day compared
to an improvement of 32 percent in patients taking sugar pill. Patients
taking both 60mg/day and 120 mg/day had significantly greater response and
remission rates compared to patients taking sugar pill.
Changes from baseline to endpoint were analyzed using ANCOVA. While the mechanism of action
of duloxetine is not fully known, scientists believe its effect on both
emotional symptoms and pain perception is due to increasing the activity of
serotonin and norepinephrine in the central nervous system. Women who are
pregnant should talk with their doctor before taking Cymbalta.Cymbalta.nih. "Diagnostic and Statistical Manual of Mental Disorders - Fourth
Edition.
The number of companies making vaccines has declined from 26 in 1967, to
17 in 1980, to just five in 2004. "Vaccines are used at most several times in a lifetime; drugs are often
used every day," writes Dr. A 1986 lawsuit claiming that pertussis vaccine caused paralysis
in a child yielded a jury award of $1.

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Functional outcomes, such as the
ability to complete everyday activities at work, home, and in social
situations, were
measured using the Sheehan Disability Scale (SDS), the Quality of Life
Enjoyment and Satisfaction
Questionnaire short form (Q-LES-Q-SF) and the European Quality of Life 5
Dimensions (EQ-5D). Cymbalta is not approved for use in
patients under the age of 18. Be especially
observant at the beginning of antidepressive treatment or whenever there is
a change in dose." 1994, pp 472-476.S.

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Study Highlights

-- Compared to sugar pill, patients receiving Cymbalta 60mg/day and
120mg/day experienced significant improvement in symptom severity
and disability associated with generalized anxiety disorder, including:

-- Significantly greater improvement in the severity of anxiety
symptoms , such as anxious mood, fears, and tension, as measured
by the Hamilton Anxiety Scale.

Headquartered in Indianapolis, Ind. Additional information about Lilly is available at www. Lilly undertakes no duty to update forward-looking
statements. Expert at The Children's Hospital of Philadelphia Analyzes Why Manufacturers
Have Abandoned Vaccines

PHILADELPHIA , Recent shortages of vaccines, most
recently the flu vaccine during the past winter, are not short -term glitches -
they reflect long-term problems in the vaccine industry. Today the federal
government 's Vaccines for Children Program is the largest single purchaser of
vaccines. Offit notes, creates a functional cap on vaccine
prices, and also shrinks the private market - which today is mostly insurance
companies.

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Pain was
assessed using a Visual Analogue Scale. Talk
with your doctor before taking Cymbalta if you have liver or kidney
problems, glaucoma or consume large quantities of alcohol.htm .
Offit, vaccines bring in 6 percent or less of their total revenue. He also urges correcting weaknesses in the National Vaccine
Injury Compensation Program to lower the costs of vaccine production.

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PRESS RELEASE Study Suggests Cymbalta(R) Significantly Reduces Core Anxiety Symptoms of Generalized Anxiety Disorder

Cymbalta is approved in the United States for the treatment of major
depressive disorder and the management of diabetic peripheral neuropathic
pain, both in adults. For most people , the nausea was mild to moderate, and usually
subsided within one-to-two weeks." Available at: http: //www.
Accessed on: February 6, 2006

(4) National Mental Health Association.org/GettingHelp /AnxietyDisorders/chart.
Insurance companies, for their part, often provide low or inconsistent
reimbursement to physicians for vaccines.

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About Generalized Anxiety Disorder

Approximately four million Americans are diagnosed with generalized anxiety
disorder each year. Nursing
while taking Cymbalta is not recommended.

About Eli Lilly and Company

Lilly (NYSE: LLY), a leading innovation-driven corporation, is developing a
growing portfolio of first-in-class and best-in-class pharmaceutical
products by applying the latest research from its own worldwide
laboratories and from collaborations with eminent scientific organizations.cfm.org/pbedu/anxiety/anxdis.

nlm roundworm

Methods

In this study of patients with generalized anxiety disorder, 168 patients
were randomly assigned to receive 60mg of Cymbalta a day, 170 patients
received 120mg of Cymbalta a day and 175 patients received a sugar pill. Tell your doctor if you are
taking other prescription or nonprescription medications . For further discussion of these and other risks
and uncertainties, see Lilly's filings with the United States Securities
and Exchange Commission." Available at:
http://www.

Is the Vaccine Industry Ailing?

Offit analyzes why pharmaceutical companies have abandoned vaccines, and urges
legislators to protect vaccines as a vital instrument of public health.
Furthermore, larger pharmaceutical companies have acquired firms that
previously had vaccines as their sole or primary product. Neither insurance companies nor the
government support the infrastructure needed to schedule appointments , keep
records, and hire nurses to administer vaccine shots. Offit, flaws in
this program limit its effectiveness. As a researcher, he has developed a vaccine
for rotavirus, the leading worldwide cause of infant deaths from infectious
disease. Its pediatric research program is
among the largest in the country, ranking second in National Institutes of
Health funding.

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Cymbalta is not approved for use in pediatric
patients. If you
have recently taken a type of antidepressant called a monoamine oxidase
inhibitor (MAOI), are taking Mellaril (thioridazine) or have
uncontrolled narrow-angle glaucoma, you should not take Cymbalta.
Among the four large pharmaceutical companies still making vaccines, says Dr. is chief of Infectious Diseases at
The Children's Hospital of Philadelphia and the Henle Professor of Immunologic
and Infectious Diseases at Children's Hospital and the University of
Pennsylvania School of Medicine.edu.

othe standpoints

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The primary endpoint of the study was effect
on anxiety symptoms as measured by the Hamilton Anxiety Scale (HAMA). It is common for anxiety disorders to be associated with other
disorders, such as depression. Patients who are starting therapy should be observed
closely for worsening depression symptoms, suicidal thoughts or behavior,
or unusual changes in behavior.

In clinical studies of Cymbalta for depression, the most common side
effects were nausea, dry mouth, constipation, decreased appetite, fatigue,
sleepiness, and increased sweating . Offit, M.D.
In a commentary article in the May/June issue of "Health Affairs," Dr. Offit, a
series of events has made the manufacture of vaccines more expensive, and
their sale less profitable . Although no scientific evidence
backed the claim that pertussis vaccine caused paralysis, writes Dr.

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-- Compared to sugar pill, patients receiving Cymbalta 60mg/day and
120mg/day reported significant improvement in ratings on the Visual
Analogue Scale for Pain for each of the following pain items:

-- Overall pain (average improvement 60mg = 41%, 120mg = 37%,
sugar pill = 16%)

-- Headaches (34%, 38%, 13%, respectively)

-- Back pain (44%, 46%, 14%, respectively)

-- Shoulder pain (47%, 43%, 19%, respectively)

-- Interference due to pain (39%, 41%, 10%, respectively)

-- Pain during waking hours (42%, 43%, 12%, respectively)

-- In this study, the most common adverse events (occurred at a rate
of +gt; =5 percent and at least twice the rate of placebo) were nausea,
dizziness , dry mouth, fatigue, hyperhidrosis, insomnia, constipation,
diarrhea, decreased libido, anorexia , somnolence, vomiting and sedation. Based on
pre-clinical studies, duloxetine is a balanced and potent reuptake
inhibitor of serotonin and norepinephrine. Anyone considering the use of Cymbalta or any other
antidepressant in a child or adolescent must balance the risk with the
clinical need.

For full Patient Information, visit www.gov/publicat/gadfacts.
Finally, product liability lawsuits have sharply raised costs to vaccine
manufacturers.

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Cymbalta patients also reported greater improvement in quality of life as
measured by the Sheehan Disability Scale, Quality of Life Enjoyment and
Satisfaction Questionnaire and European Quality of Life 5 Dimensions,
including improved ability to perform everyday activities at work, home,
and in social situations compared to sugar pill. He cites the vaccine against pneumococcal
disease in children, which has annual U.S. That program, Dr . Offit, M.

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(6)

Disturbances of serotonin and/or norepinephrine may explain the presence of
both the emotional and physical symptoms of depression.cfm. Although some of these changes result from
mergers among pharmaceutical companies, for the most part, says Dr.
Other market forces have made vaccines less profitable. Fifty years ago, a
large private market of doctors purchased polio vaccines. Families can choose to opt out of the
program and proceed to a jury trial, the program does not cover all vaccines,
and it does not cover effects on an unborn child when the mother is
vaccinated. newborns each year.
Dr. He also is director of the Hospital's Vaccine Education Center, which
provides up-to-date, reliable information about vaccines to thousands of
parents and healthcare professionals throughout the United States. In addition, its unique family-centered care and public
service programs have brought the 430-bed hospital recognition as a leading
advocate for children and adolescents .

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Important Safety Information

In clinical studies, antidepressants increased the risk of suicidal
thinking and behavior in children and adolescents with depression and other
psychiatric disorders., chief of Infectious Diseases at The Children's Hospital
of Philadelphia.
To begin with, the market for vaccines is small compared to that for
drugs. So in competing
against drugs for a company's internal resources, vaccines most often lose.

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Don't stop taking Cymbalta without talking to your
doctor.

(1) Duloxetine as an Effective Treatment for Improving Painful Physical
Symptoms and Functioning Associated with Generalized Anxiety Disorder; C
Allgulander, H Koponen, J Erickson , Y Pritchett, M Detke, S Ball, J Russell

(2) A Fixed Dose Study of the Efficacy and Safety of Duloxetine for the
Treatment of Generalized Anxiety Disorder; H Koponen, C Allgulander, Y
Pritchett , J Erickson, M Detke, S Ball, J Russell

(3) National Institute of Mental Health.

(6) Anxiety Disorders Association of America "Medications for Anxiety
Disorders" Available at:
http://www . Accessed on
March 13, 2006.
"The technology is in hand to prevent many infections that routinely
hospitalize and kill people in the United States and the world," he concludes. For more information , visit
http://www.

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Results will be announced on Saturday, March 25, in two separate
presentations (1), (2) at the Anxiety Disorders Association of America
(ADAA) Annual Conference. "These data
suggest that not only was Cymbalta able to significantly improve the core
anxiety symptoms, but it also reduced painful physical symptoms associated
with the disorder and improved functioning resulting in improved quality of
life. Secondary
measures included effects on associated pain and functioning. Your doctor may periodically check
your blood pressure.com.

This press release contains forward -looking statements about the potential
of Cymbalta for the treatment of generalized anxiety disorder , and reflects
Lilly's current beliefs.

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"

"We are encouraged by these results that suggest Cymbalta may address a
broad range of core anxiety symptoms and the associated physical symptoms
that are often reported in patients with generalized anxiety disorder,"
said James Russell, MD, Medical Advisor , Eli Lilly and Company. Accessed on: February 7,
2006

(5) APA.

About the author: Paul A.

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(3) Symptoms persist for at least six months and can
include exaggerated worry or chronic anxiety and irritability, which can
lead to poor concentration, and procrastination, as well as physical
symptoms like muscle tension, fatigue and nausea. The illness also tends to be chronic with periods of
exacerbation and remission.

Prescription Cymbalta is not for everyone.Cymbalta . A variety of social,
legal and economic forces have caused pharmaceutical companies to withdraw
their commitment to vaccines, according to pediatrician and vaccine expert
Paul A.

About The Children's Hospital of Philadelphia: The Children's Hospital of
Philadelphia was founded in 1855 as the nation's first pediatric hospital.

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In addition,
Cymbalta significantly reduced overall pain by 41 percent and 37 percent
respectively, compared to 16 percent in patients taking sugar pill .(5)

About Cymbalta

Serotonin and norepinephrine in the brain and spinal cord are believed to
both mediate core depression symptoms and help regulate the perception of
pain. In clinical studies of Cymbalta in these patients, the most
common side effects were nausea, sleepiness, dizziness , constipation, dry
mouth, increased sweating, decreased appetite, and loss of strength or
energy . gross sales of about $1 billion,
the highest revenue generated by a vaccine. Fearful of litigation , no pharmaceutical company is willing to
produce a vaccine known to protect newborns from a group B streptococcus
infection, a disease that kills 100 U. Offit recommends that Congress take steps to increase vaccination
coverage by offering financial incentives to manufacturers and healthcare
professionals. Finally,
he proposes that public-private partnerships could improve vaccine
development .

nlm biomedicine

Call the
doctor if you have thoughts of suicide or if any of these symptoms are
severe or occur suddenly. People who are allergic to
Cymbalta or the other ingredients in Cymbalta should not take it. Nausea was the most common side
effect. Offit. Broader public support
for vaccines, best exemplified in the great polio vaccination campaigns of the
1950s, has declined, while anti-vaccine organizations have grown.

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