References 1. Greenberg PE, Sisitsky T, Kessler RC, et al. The economic burden of anxiety disorders in the 1990s. J Clin Psychiatry. 1999;60(7):427–435. 2. American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 4th ed., text revision. Washington DC: American Psychiatric Press, Inc; 2000. 3. Koponen H, Allgulander C. Efﬁcacy of duloxetine for the treatment of generalized anxiety disorder: implications for primary care physicians. Prim Care Comp J Clin Psychiatry. 2007;9(2):100–107. 4. Wittchen H-U, Hoyner J. Generalized anxiety disorder: nature and course. J Clin Psychiatry. 2001;62(suppl 1)1:15–10. 5. Butler G, Fennel M, Robson P, Gelder M. Comparison of behavior therapy and cognitive behavior therapy in the treatment of generalized anxiety disorder. J Consult Clin Psychol. 1991;59:167–175. 6. Preskorn SH. Milnacipran: A dual norepinephrine and serotonin reuptake pump inhibitor. J Psychiatr Pract. 2004;10:119–126. 7. Eli Lilly. Duloxetine package insert, September 2004. Available at www.insidecymbalta.com. 8. Eli Lilly [online]: www.lilly.com. 9. Preskorn SH. Duloxetine. J Psychiatr Pract. 2004;10(6):375–385. 10. Gupta S, Nihalani N. Duloxetine: review of its pharmacology, and therapeutic use in depression and other psychiatric disorders. Ann Clin Psychiatry. 2007;19(2):125–132. 11. Skinner MH, Kuan HY, Sathirakul K, et al. Duloxetine is both an inhibitor and a substrate of cytochrome P4502D6 in healthy volunteers. Clin Pharmacol Ther. 2003;73:170–177. 12. Physicians Desk Reference. 62nd ed. Montrale, NJ: Thomson Healthcare Inc.; 2008. p. 1791–1798. 13. Rynn M, Russell J, Erickson J, et al. Efﬁcacy and safety of dulox- etine in the treatment of generalized anxiety disorder: a flexible dose, progressive titration, placebo-controlled trial. Depress Anxiety. 2008;25(3):182–189. 14. Hartford J, Kornstein S, Liebowitz M, et al. Duloxetine as an SNRI treatment for generalized anxiety disorder: results from a placebo and active-controlled trial. Int Clin Psychopharm. 2007;22:167–174. 15. Sharma A, Goldberg MJ, Cerimele BJ. Pharmacokinetics and safety of duloxetine, a dual-serotonin and norepinephrine reuptake inhibitor. J Clin Pharmacol. 2000;40:161–167. 16. Davidson J, Allgulander C. Efﬁcacy and tolerability of duloxetine in elderly patients with generalized anxiety disorder: a pooled analysis of four randomized, double-blind, placebo-controlled studies. Hum Psychopharmacol Clin Exp. 2008;23:519–526. Duloxetine for GAD 17. Lantz RJ, Gillespie TA, Rash TJ, et al. Metabolism, excretion, and pharmacokinetics of duloxetine in healthy human subjects. Drug Metab Dispos. 2003;31:1142–1150. 18. Karpa KD, Cavanaugh JE, Lakoski JM. Duloxetine pharmacology: Proﬁle of a dual monoamine modulator. CNS Drug Rev. 2002;8:361–376. 19. Parikh AR, Thatcher BT, Tamano EA, Liskow BI. Suicidal ideation associated with duloxetine use: a case series. J Clin Psychopharm. 2008;28(1):101–102. 20. Tunis SR, Stryer DB, Clancy CM. Practical clinical trials: increasing the value of clinical research for decision making in clinical and health policy. JAMA. 2003;290:1624–1632. 21. Davidson J, Wittchen HU. Duloxetine treatment for relapse prevention in adults with generalized anxiety disorder: A double-blind placebo-controlled trial. J Euro Neuro. 2008;18:673–681. 22. Pollack MH, Kornstein SG, Spann ME, Crits-Christoph P, Raskin J, Russell JM. Early improvement during duloxetine treatment of generalized. J Psychiatr Res. 2008;42(14):1176–1184. 23. Pollack MH, et al. Examining quality of life in patient’s with generalized anxiety disorder. J Psychiatr Res. 2008; doi: 10.1016/ j.jpsychires. 2007.11.006. 24. Kessler RC, DuPont RL, Berglund P, et al. Impairment in pure and comorbid generalized anxiety disorder and major depression at 12 months in two national surveys. Am J Psychiatry. 1999;156:1915–1923. 25. Endicott J, Russell JM, Raskin J, et al. Duloxetine treatment for role functioning improvement in generalized anxiety disorder: three independent studies. J Clin Psychiatry. 2007;68(4):518–524. 26. Russell J, Weisberg R. Efﬁcacy of duloxetine in the treatment of generalized anxiety disorder in patients with clinically signiﬁcant pain symptoms. Depress Anxiety. 2008;25:E1–E11. 27. Hartford J, Endicott J. Implications of pain in generalized anxiety disorder: efficacy of duloxetine. Prim Care Companion J Clin Psychiatry. 2008;10(3). 28. Rickels K, Pollack MH, Sheehan DV, Haskins JT. Efﬁcacy of extended- release venlafaxine in nondepressed outpatients with generalized anxiety disorder. Am J Psych. 2000;157:968–974. 29. Gelenberg A, Lydiard RB, Rudolph RL, Aquiar L, Haskins JT, Salinas E. Efficacy of venlafaxine extended-release capsules in nondepressed outpatients with generalized anxiety disorder: a 6 month randomized controlled trial. JAMA. 2000;283(23):3082–3088. 30. US Institute of Health, Clinical Trials Registry. Available from www. clinicaltrials.gov. Neuropsychiatric Disease and Treatment 2009:5 31