CHAPTER THREE: INDUSTRY OVERVIEW... 6 HISTORICAL PERSPECTIVE OF THE MENTAL HEALTH INDUSTRY... 6 HISTORICAL PERSPECTIVE OF THE (CONTINUED)...

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1 CHAPTER ONE: INTRODUCTION... 1 STUDY GOALS AND OBJECTIVES... 1 REASONS FOR STUDY... 1 SCOPE OF STUDY... 1 METHODOLOGY AND INFORMATION SOURCES... 2 ANALYST CREDENTIALS... 2 RELATED BCC REPORTS... 2 DISCLAIMER... 3 CHAPTER TWO: EXECUTIVE SUMMARY... 4 EXECUTIVE SUMMARY... 4 SMMARY TABLE TOTAL MARKET FOR DEPRESSIVE AND ANXIETY DISORDERS, THROUGH 2014 ($ MILLIONS)... 5 SUMMARY FIGURE TOTAL MARKET FOR DEPRESSIVE AND ANXIETY DISORDERS, ($ MILLIONS)... 5 CHAPTER THREE: INDUSTRY OVERVIEW... 6 HISTORICAL PERSPECTIVE OF THE MENTAL HEALTH INDUSTRY... 6 HISTORICAL PERSPECTIVE OF THE (CONTINUED)... 7 HISTORICAL PERSPECTIVE OF THE (CONTINUED)... 8 HISTORICAL PERSPECTIVE OF THE (CONTINUED)... 9 HISTORICAL PERSPECTIVE OF THE (CONTINUED) HISTORICAL PERSPECTIVE OF THE (CONTINUED) HISTORICAL PERSPECTIVE OF THE (CONTINUED) HISTORICAL PERSPECTIVE OF THE (CONTINUED) INTRODUCTION TO THE NERVOUS SYSTEM AND BRAIN INTRODUCTION TO THE (CONTINUED) BLOOD-BRAIN BARRIER DEMOGRAPHICS TABLE 1 WORLD POPULATION BY SELECTED GEOGRAPHICAL REGION, (MILLIONS) FIGURE 1 WORLD POPULATION BY SELECTED GEOGRAPHICAL REGION, (MILLIONS) TABLE 2 ESTIMATED WORLD POPULATION BY AGE AND GEOGRAPHICAL REGION, 2008 (MILLIONS) FIGURE 2 ESTIMATED WORLD POPULATION BY AGE AND GEOGRAPHICAL REGION, 2008 (MILLIONS) TABLE 3 POPULATION OVER 65 BY YEAR AND REGION, (%) FIGURE 3 POPULATION OVER 65 BY YEAR AND REGION, PREVALENCE OF MENTAL DISORDERS TABLE 4 BEST ESTIMATE 1-YEAR PREVALENCE RATES BASED ON ECA AND NCS, AGES (%) TABLE 4 (CONTINUED)... 22

2 TABLE 5 PERCENTAGE OF INDIVIDUALS 12 YEARS AND OLDER WITH DEPRESSION BY DEMOGRAPHIC CHARACTERISTIC AGE, SEX, AND RACE, U.S (%) TABLE 6 PERCENTAGE OF INDIVIDUALS WITH DEPRESSION BY AGE AND POVERTY STATUS, UNITED STATES 2006 (%) TABLE 7 INDIVIDUALS 12 YEAR OF AGE AND OLDER REPORTING DIFFICULTY WITH THEIR WORK, HOME, AND SOCIAL ACTIVITIES BY SEX AND DEPRESSION SEVERITY, UNITED STATES, 2006 (%) TABLE 8 INDIVIDUALS 12 YEARS OF AGE AND OLDER CONTACTING A MENTAL HEALTH PROFESSIONAL IN THE PAST 12 MONTHS, BY DEPRESSION SEVERITY, UNITED STATES 2006 (%) CHILDREN AND ADOLESCENTS OLDER ADULTS COSTS OF MENTAL ILLNESS TABLE 9 BEST ESTIMATE PREVALENCE RATES BASED ON EPIDEMIOLOGICAL CATCHMENT AREA, AGE 55+ (%) DEPRESSIVE DISORDERS MAJOR DEPRESSION Etiology and Neurobiology TABLE 10 RISK FACTORS FOR MAJOR DEPRESSIVE AND BIPOLAR DISORDERS TABLE 11 PREFRONTAL CORTEX AND SEROTONIN INTERCONNECTIONS: IMPLICATIONS IN DEPRESSION TABLE 11 (CONTINUED) Clinical Manifestations BIPOLAR DISORDER Etiology and Neurobiology Clinical Manifestations Bipolar I Disorder Bipolar II Disorder Bipolar II Disorder (Continued) SEASONAL AFFECTIVE DISORDER Clinical Manifestations ANXIETY DISORDERS Panic Disorder Etiology and Neurobiology Etiology and Neurobiology (Continued) Clinical Manifestations Generalized Anxiety Disorder Etiology and Neurobiology Etiology and Neurobiology (Continued) Clinical Manifestations Obsessive-Compulsive Disorder Etiology and Neurobiology... 44

3 Clinical Manifestations Specific and Social Phobias TABLE 12 CLINICAL NAMES FOR COMMON PHOBIAS Post-Traumatic Stress Disorder GENERIC INFLUENCE ELDERLY IMPACT DEPRESSION ANXIETY CHILDREN AND ADOLESCENT IMPACT DEPRESSION Symptoms of Depression in Children Symptoms of Depression in Children (Continued) ANXIETY ALTERNATIVE AND COMPLEMENTARY THERAPIES ST. JOHN S WORT (HYPERFORIN AND HYPERICIN) VALERIAN ROOT HTP RHODIOLA ROSEA SAM-E BACOPA GINSENG B VITAMINS - B1, B3, B5, B6, B9, AND B ZINC MAGNESIUM KAVA KAVA OVERUSE OF ANTIDEPRESSANTS ANOTHER VIEW LEGISLATIVE ISSUES COMPLIANCE ISSUES COMPLIANCE ISSUES (CONTINUED) PRESCRIBING TRENDS DEPRESSION RISK DUE TO BRAIN THINNING DEPRESSION RISK DUE TO (CONTINUED) SUICIDAL BEHAVIOR AND ANTIDEPRESSANTS NOVEL APPROACH IN TEEN SUICIDE COMBINATION THERAPY REMOTE SUPPORT FOR DEPRESSION TREATMENTS AND PRODUCTS FOR DEPRESSIVE DISORDERS TREATMENTS AND PRODUCTS FOR (CONTINUED) PRESCRIPTION PRODUCTS Selective Serotonin Reuptake Inhibitors Side Effects Pharmacologics Serotonin-Norepinephrine Reuptake Inhibitors Tricyclic Antidepressants... 69

4 Chemical Aspects Mechanism of Action Actions and Side Effects Pharmacologics Monoamine Inhibitors Chemical Aspects Pharmacologics Side Effects Others Marketed Antidepressants Marketed Antidepressants (Continued) Marketed Antidepressants (Continued) Marketed Antidepressants (Continued) TABLE 13 SELECTED MARKETED ANTIDEPRESSANT DRUGS ($ MILLIONS) ALTERNATIVE TREATMENTS Light Therapy Electroconvulsive Therapy Acupressure Acupuncture Biofeedback Nutrition Reflexology Self-Help Groups Animal-Assisted Therapies Expressive Therapies Art Therapy Dance/Movement Therapy Music/Sound Therapy Guided Imagery or Visualization Massage Therapy Technology-Based Applications Telemedicine Telephone Counseling Electronic Communications Radio Psychiatry Vagus Nerve Stimulation (VNS) Transcranial Magnetic Stimulation (TMS) Deep Brain Stimulation TREATMENTS AND PRODUCTS FOR ANXIETY DISORDERS PRESCRIPTION PRODUCTS Barbiturates Benzodiazepines Tricyclic Antidepressants... 87

5 Selective Serotonin Reuptake Inhibitors Serotonin-Norepinephrine Reuptake Inhibitors Effexor Cymbalta Antihistamines Anticonvulsants/Bipolar Lamictal Lithium Beta-Blockers Antipsychotics Abilify BuSpar Geodon Risperdal Seroquel Zyprexa TABLE 14 SELECTED MARKETEDANTIANXIETY DRUGS TABLE 14 (CONTINUED) CHAPTER FOUR: MARKET SIZE AND GROWTH TOTAL MARKET Total Antidepressant and Antianxiety Drug Market by Product Classification TABLE 15 TOTAL MARKET FOR DEPRESSIVE AND ANXIETY DISORDERS, THROUGH 2014 ($ MILLIONS) FIGURE 4 TOTAL MARKET FOR DEPRESSIVE AND ANXIETY DISORDERS, ($ MILLIONS) TABLE 16 TOTAL MARKET SHARE BY CATEGORY, 2009 AND 2014 (%) FIGURE 5 TOTAL MARKET SHARE BY CATEGORY, 2009 AND 2014 (%) TOTAL ANTIDEPRESSANT AND ANTIANXIETY DRUG MARKET BY GEOGRAPHIC SEGMENTS FIGURE 6 GLOBAL MARKET SIZE OF THERAPIES FOR DEPRESSIVE AND ANXIETY DISORDERS BY REGION, ($ MILLIONS) TABLE 18 TOTAL MARKET SHARE BY REGION, 2009 AND 2014 (%) FIGURE 7 TOTAL MARKET SHARE BY REGION, 2009 AND 2014 (%) DEPRESSION MARKET ANTIDEPRESSANT DRUG MARKET BY PRODUCT CLASSIFICATION TABLE 19 GLOBAL MARKET FOR ANTIDEPRESSANTS BY PRODUCT, THROUGH 2014 ($ MILLIONS) FIGURE 8 GLOBAL MARKET FOR ANTIDEPRESSANTS BY PRODUCT, ($ MILLIONS)

6 TABLE 20 GLOBAL MARKET SHARE OF ANTIDEPRESSANTS BY PRODUCT, THROUGH 2014 (%) FIGURE 9 GLOBAL MARKET SHARE OF ANTIDEPRESSANTS BY PRODUCT, (%) ANTIDEPRESSANT DRUG MARKET BY GEOGRAPHIC SEGMENTS United States European Union Japan Rest of World TABLE 21 GLOBAL MARKET FOR ANTIDEPRESSANTS BY REGION, ($ MILLIONS) FIGURE 10 GLOBAL MARKET FOR ANTIDEPRESSANTS BY REGION, ($ MILLIONS) TABLE 22 GLOBAL MARKET SHARE OF GLOBAL ANTIDEPRESSANTS BY REGION, (%) FIGURE 11 GLOBAL MARKET SHARE OF GLOBAL ANTIDEPRESSANTS BY REGION, (%) ANTIANXIETY MARKET ANTIANXIETY DRUG MARKET BY PRODUCT CLASSIFICATION TABLE 23 GLOBAL MARKET FOR ANTIANXIETY DRUGS BY PRODUCT TYPE, THROUGH 2014 ($ MILLIONS) TABLE 24 GLOBAL MARKET SHARE OF ANTIANXIETY DRUGS BY PRODUCT TYPE, (%) FIGURE 12 GLOBAL MARKET FOR ANTIANXIETY DRUGS BY PRODUCT TYPE, ($ MILLIONS) FIGURE 13 GLOBAL MARKET SHARE OF ANTIANXIETY DRUGS BY PRODUCT TYPE, (%) ANTIANXIETY DRUG MARKET BY GEOGRAPHIC SEGMENTS United States European Union Japan Rest of World TABLE 25 GLOBAL MARKET SIZE OF ANTIANXIETY DRUGS BY REGION, THROUGH 2014 ($ MILLIONS) FIGURE 14 GLOBAL MARKET SIZE OF ANTIANXIETY DRUGS BY REGION, ($ MILLIONS) TABLE 26 GLOBAL MARKET SHARE OF GLOBAL ANTIANXIETY DRUGS BY REGION, (%) FIGURE 15 GLOBAL MARKET SHARE OF GLOBAL ANTIANXIETY DRUGS BY REGION, (%) CHAPTER FIVE: RESEARCH AND DEVELOPMENT

7 GEODON GEPIRONE ER RISPERDAL CONSTA SAPHRIS SEROQUEL XR TRAZODONE ONCE DAILY AGI CORLUX INVEGA LU AA LYRICA NUVIGIL SAREDUTANT VILAZODONE TABLE 27 THERAPIES IN DEVELOPMENT FOR DEPRESSION AND ANXIETY, TABLE 27 (CONTINUED) NOVEL PRODUCTS IN DEVELOPMENT NOVEL PRODUCTS IN DEVELOPMENT (CONTINUED) CHAPTER SIX: COMPETITIVE ANALYSIS TOTAL COMPETITIVE ANALYSIS TABLE 28 TOTAL COMPETITIVE ANALYSIS OF THERAPIES FOR DEPRESSION AND ANXIETY DISORDERS BY DRUG MANUFACTURER MARKET SHARE, 2008 ($ MILLIONS/%) FIGURE 16 TOTAL COMPETITIVE ANALYSIS OF THERAPIES FOR DEPRESSION AND ANXIETY DISORDERS BY DRUG MANUFACTURER MARKET SHARE, 2008 (%) DEPRESSION COMPETITIVE ANALYSIS TABLE 29 COMPETITIVE ANALYSIS OF THERAPIES FOR DEPRESSION DISORDERS BY DRUG MANUFACTURER MARKET SHARE, 2008 ($ MILLIONS/%) FIGURE 17 COMPETITIVE ANALYSIS OF THERAPIES FOR DEPRESSION DISORDERS BY DRUG MANUFACTURER MARKET SHARE, 2008 (%) TABLE 30 COMPETITIVE ANALYSIS OF THERAPIES FOR DEPRESSION DISORDERS BY THE TOP FOUR DRUG MANUFACTURERS MARKET SHARE, 2008 ($ MILLIONS/%) FIGURE 18 COMPETITIVE ANALYSIS OF THERAPIES FOR DEPRESSION DISORDERS BY THE TOP FOUR DRUG MANUFACTURERS MARKET SHARE, 2008 (%) ANTIANXIETY COMPETITIVE ANALYSIS

8 TABLE 31 COMPETITIVE ANALYSIS OF THERAPIES FOR ANXIETY DISORDERS BY DRUG MANUFACTURER MARKET SHARE, 2008 ($ MILLIONS/%) TABLE 32 COMPETITIVE ANALYSIS OF THERAPIES FOR ANXIETY DISORDERS BY THE TOP FOUR DRUG MANUFACTURER MARKET SHARE, 2008 ($ MILLIONS/%) FIGURE 19 COMPETITIVE ANALYSIS OF THERAPIES FOR ANXIETY DISORDERS BY DRUG MANUFACTURER MARKET SHARE, 2008 (%) FIGURE 20 COMPETITIVE ANALYSIS OF THERAPIES FOR ANXIETY DISORDERS BY THE TOP FOUR DRUG MANUFACTURER MARKET SHARE, 2008 (%) CHAPTER SEVEN: PATENT ANALYSIS TABLE 33 SELECTED MANUFACTURER PATENTS FOR TREATMENT OF DEPRESSION AND ANXIETY CHAPTER EIGHT: COMPANY PROFILES ASTRAZENECA BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 34 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT BRISTOL-MYERS SQUIBB COMPANY BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 35 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT DOV PHARMACEUTICAL, INC BRIEF HISTORY PRODUCTS RESEARCH AND DEVELOPMENT ELI LILLY & COMPANY BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 36 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT FABRE-KRAMER PHARMACEUTICALS, INC BRIEF HISTORY PRODUCTS RESEARCH AND DEVELOPMENT FOREST PHARMACEUTICALS, INC

9 BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 37 COMPANY REVENUES, 2007 AND 2008 ($ BILLIONS) RESEARCH AND DEVELOPMENT GLAXOSMITHKLINE BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 38 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT JAZZ PHARMACEUTICALS, INC BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 39 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT JOHNSON & JOHNSON BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 40 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT H. LUNDBECK A/S BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 41 COMPANY REVENUES 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT MERCK & COMPANY, INC BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 42 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT PFIZER, INC BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 43 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT ROCHE, INC BRIEF HISTORY PRODUCTS

10 COMPANY REVENUE HISTORY TABLE 44 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT SANOFI-AVENTIS BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 45 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT SEPRACOR, INC BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 46 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT SCHERING-PLOUGH CORP BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 47 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT WYETH BRIEF HISTORY PRODUCTS COMPANY REVENUE HISTORY TABLE 48 COMPANY REVENUES, 2007 AND 2008 ($ MILLIONS) RESEARCH AND DEVELOPMENT APPENDIX A ALTERNATIVE APPROACHES TO MENTAL HEALTH ORGANIZATIONS ALTERNATIVE APPROACHES TO (CONTINUED) APPENDIX B COMPANY LISTINGS TABLE 49 COMPANY LISTINGS TABLE 49 (CONTINUED) TABLE 49 (CONTINUED) TABLE 49 (CONTINUED) TABLE 49 (CONTINUED) TABLE 49 (CONTINUED) TABLE 49 (CONTINUED)