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This is Anal Sex Advice Part 2. Most people are willing to try playing outside their partners anus with a finger. In women the closeness of the anus to the vagina means that most men are likely to be on nodding terms with their partners anus anyway, so its a small step to incorporating anal play into the sex they have together. I think at this point its worth reminding you that when people are sexually aroused they often find something acceptable which theyd never contemplate when they were less aroused - and that includes anal play. Which is not to say that you can suddenly spring the idea in the middle of lovemaking - or, worse, start pushing your finger or your penis into your partners asshole without her agreement - but it is helpful to remember that when youre well into your lovemaking, with perhaps a finger on her clit, and another gently massaging her vulva, and maybe yet another one inside her vagina, she may be more receptive to the idea than when you started making love. So - the message is, if you have agreed to explore anal sex, dont make a beeline for her rosebud. Take it slowly, and be gentle.
The movements you can use on the outside of the anus are just as varied as the ones you can use on any other part of the body. Tickling, stroking, circles, moving around the anus in circles and then moving in close to the center - I mean, just use your imagination! Varying the pressure and direction of the strokes will produce a nice and exciting feeling - and the lighter the touch, the more erotic it may seem to your partner. Just as in all massage and stroking, the key to keeping your partners interest high is in varying the strokes, perhaps alternating fast and slow movements and light and heavier ones. You will find that your partners anus will react to your touch in one of two ways depending on how relaxed he or she is - it will either gently lose its tension and the tight puckered center of the opening will relax more, or it will tighten up. In the latter case, you can ask your partner to consciously relax and reassure them that you wont be trying to go into them until they are happy about it.
Playing around and massaging the area near the anus, or the opening itself, but without trying to get in, is often the first step that helps a partner relax and learn to enjoy anal play. So many of us in the west are anally retentive - and even if were not, a lot of us have tension and fear stuck in this part of the body. A relaxed person tends to have a relaxed anus - so this play might increase your overall sense of well-being, as well as give you some fun!

And of course even better is to play with your own anus if youre tense in that area. Some techniques for learning to let go of anal tension are: to alternately clench your anus and then relax it, so as to learn the difference in feel between the two states; to play with it yourself while youre taking a bath or shower - this can really help you learn how to let go and accept a finger up inside it (I mean, youre more likely to trust yourself with your own anus than anyone else, I guess); and to incorporate some anal play into your masturbation.
Oral play around the anus - which is known as analingus - may be more of a problem for some men than actually putting your penis inside her anus. As for women, I havent got any statistics, but I should think there might be a bit of resistance to the idea of putting your mouth and tongue on or into your mans anus. And yet, it can be very enjoyable for both parties. Apart from the naughty intimacy of it (I mean, how many people in your life are you going to do this to?), the sensations can be exquisite as a warm moist tongue licks and caresses those sensitive nerve endings.
A light flicking, a heavy probing with the tip of your tongue into your partners anus, a flattened tongue pressing against the outside of the whole area, a sucking or licking action on the perineum, or any combination of these, can be very exciting. If you are a man doing this to a woman, then you will certainly want to be giving some attention to her clitoris as well, to keep her arousal and interest up.
If anal sex is to be enjoyable, it must not be painful! And if it is painful - something is going wrong. When a man or a woman has a relaxed anus, and is welcoming their partner into their body, both the internal and the external sphincter muscles relax, and there is no pain at all - of course, it has to be that way to make anal sex an enjoyable experience! So if there is pain: STOP. And of course make sure the receptive or passive partner knows they can say STOP if things get uncomfortable. The key to avoiding discomfort is to go slowly in the initial penetration, so that the passive partner learns how to accept and relax the entry of the finger, penis or dildo into their body.
The lining of the rectum is a mucus membrane - like the inside of the mouth - and it is more sensitive and much thinner than the walls of the vagina. So if you massage it with a finger, use the pad of your finger, and make sure your nails are well trimmed.
There are two rings of muscles at this entrance to the body, one on the outside (the external sphincter) and one deeper inside at the entry to the rectum, at the end of the anal canal. (The anal canal is the passage through the body wall that connects the open air to your rectum.) The two rings of muscle are only a half inch or so apart, but you have to pass through both to get into the rectum, and they can clamp tightly shut if they are feeling moody! The external one is easier to relax, but the internal one will clamp shut regardless of what you or your partner wishes if you are feeling anxious, fearful or frightened. Trying to get through its impenetrable barrier is then difficult and often extremely painful - not that the owner of the muscle is likely to let you try.
For men: the best way to start anal exploration with your partner is to incorporate it into your overall sex play. When a woman is getting aroused, you can play with her anus using a little pressure to begin probing her opening. Youre going to have to make some kind of judgment about how much she enjoys it (of course you could always ask her how it feels), and judge your progress accordingly.
Sharing that secret special place with your partner is, or can be, a very loving act, and the permission to enter someones body like this deserves to be respected by the penetrating partner. Its therefore important to work up to it gradually, by stroking and massaging the area around the opening, and giving the receiving partner time to get used to these new feelings. (Eventually of course, once they are confident, everything will proceed much quicker.)
Once they have given you the go-ahead, find the exact center of the opening. Its not always obvious, so do check. Once youve found it, gently press with your fingertip (and dont forget the lube), while your partner mentally and physically relaxes and welcomes your finger into their body. This has to be a conscious choice - an act of will. Often a rhythmic pushing motion helps - your finger may go further in each time until it finally slides through the two rings of muscle and enters their rectum.
A pretty good recipe for a man stimulating a woman in this way is to excite her clitoris and vulva with your tongue, while you gently massage the sensitive spots inside her vagina with one finger and gently massage her anus, anal canal or the wall of her rectum with another finger. Pressing or massaging the wall of her rectum nearest her vagina often transmits exciting sensations to her vagina. Be adventurous - play! And remember not to swap fingers between ass and vagina.
For a women stimulating a man in this way, the prostate gland is exquisitely sensitive. Normally, of course, it is hidden away, but a quirk of nature means that it can be gently massaged from inside the rectum. If a guy is lying on his back, the prostate is on the upper side of his rectum, and it can be stimulated by a finger gently massaging it through the wall of the rectum. For the lover who is massaging a mans prostate, caution is the watchword, because this allows you to establish what degree of pressure will be pleasant for him. And indeed, what sort of movement - circles, strokes, gentle pressure - whatever. Again - be adventurous, and play!
Watch out for part 3 of this series n anal sex. Find it by searching on Anal Sex Advice Part 3.
There is much more useful advice on anal sex in part 3 of this article. Find the article by searching on Anal Sex Advice Part 3.

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Pulse Diagnosis
In Western diagnostics it is only the rate of the pulse that is taken. The rate is dependant on the dominance of the Doshas in Ayurveda. Vata is 80-90 beats per minute. Pitta is 70-80 bpm. Kapha is 60-70 bpm. The rhythm of the pulse can be irregular or regular. An irregular pulse has no distinguishable pattern. Its intensity and rhythm fluctuates wildly. Vata is irregular. A regular pulse in consistent, it pumps in the same rhythm and amplitude. Its crest and wave are even. Pitta is regularly irregular, meaning that if it skips a beat it always skips that beat, and thus the pattern repeats itself. The amplitude of the pulse is the force or strength with which the beat moves into the fingers. Pitta's intensity is high, Kapha's consistency is moderate, and Vata's variability is low. Overall the characteristics of each dosha are: Vata is feeble and light as it slithers into the fingers. Pitta bounds into the fingers strongly and clearly. Kapha slides into the fingers slow and cloudlike. These are elaborated on in the table below.

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Anal Sex Advice Part 3. Anal intercourse is best enjoyed when you are both fairly aroused - but not, let me add, so aroused that you get carried away, and forget the condom, the lube, or to listen to what shes saying (for example: Stop! Stop! It hurts!). Its also a great idea to start with a finger, even if you want to get your penis in there. Weve already had a look at how you might go about getting your finger into your partners anus in a way that she enjoys, so - what do you do next? Again, the answer is, be very careful. Relaxation and slow progress are the key to successful anal sex, and of course using plenty of lube (I recommend .)
Start by looking where you are going. This isnt like going into a vagina, where the labiae will guide your penis in even if your penis is not at quite the right angle. You cant go into an anus by feel alone. You need to be sure you have targeted your entry correctly: if you try and do it by feel alone, your penis may well end up pressing into your partners perineum or some of the soft tissue around her anus. A good guide to how much resistance you will meet is the ease (or otherwise) with which you can slide a finger in - and yes, I know this is much smaller than your penis, but her anus can relax to accommodate your penis with little more difficulty than it relaxes to admit your finger.
Another helpful tip is to have your lover guide you in - this also makes her feel she has more control over the process, and that could help her relax. But you must use your own hand to guide your penis in as well. And you must go slowly. Slowly. Slowly. You can probably speed up your thrusts when your partner has had the chance to get accustomed to the feeling - but do everything slowly to start with. When you begin to seek entry, ask her if it is OK to go into her body. And if she says yes, and welcomes you in, it will help if she says this out loud as you press at her rosebud: I welcome you into my body. My body is relaxing to let you in.
As for positions - well, once you have decided on the basic approach (rear entry, side by side, woman lying on her back, or whatever) you are just going to have to try shifting position slightly until you find the right angle. Every body is slightly different inside, and the exact angle which will allow your penis in will be a matter for each couple to establish for themselves. The positions are not that different to normal vaginal sex: they just need slight modification, such as her legs being farther apart.

Perhaps the best way to get in is to use a kind of slight pumping or thrusting movement, starting by pressing at the opening, and then just adding a bit of pressure, then withdrawing, then going back again with a tiny bit more pressure - and so on. The sensation of your penis head - if that is the largest part of your penis - going through her anal canal may be strange, but it can actually be quite erotic, pleasant and arousing.
Of course, to feel pleasant, it has to be painless, and to be painless she has to be pretty relaxed and you have to be well lubed. You may have an advantage on getting in if your penis head is pointy and small, because it will ease her open gently and hopefully allow your larger penis shaft to get in behind it.
Very small cuts and tears are common when you go into the anus. Dont panic - these are just small lesions you will never notice, like the ones you get in your mouth every time you brush your teeth (no - you never notice them either). But unless you are absolutely sure of your partners sexual history, this is a compelling reason for using a condom. The best combination is probably an unlubricated condom with plenty of Probe lubricant.
So - assuming you have gone slowly, and gently, you will probably now be deep inside your lover, connected in a very special way. Anal sex is a privilege for a man - I think it demands a lot of a woman, and it can be a real test of trust. Having said that, many women do enjoy it, and it can become a regular feature of a couples sex life. So once youve both got used to it, and she is able to relax sufficiently to let her anus admit you and accommodate your thrusting, what do you do next? I guess you try other positions that will allow you to kiss, fondle and hold each other while you are inside her. One example would be to have the woman on top while she straddles you.
And a position where the man can thrust gently and intermittently so as to extend the time before he comes, while he can reach her vagina and massage her G spot and clit with his fingers could be helpful in allowing a couple to reach simultaneous orgasm - its certainly worth a try.
Anal intercourse can be taken a stage further. The woman can penetrate the man in this way, too. No, this isnt a mistake. A woman can penetrate her man up the anus - and those couples who are into it seem to think it is rather delightful. And no, it doesnt mean that youre a repressed gay man (for goodness sake. As if enjoying the erotic sensations of your anus is a problem). Anyhow, the obvious question is and the obvious answer is - she uses a strap-on penis.
OK, let me explain. It all centers, of course, on the prostate, that exquisitely sensitive area of tissue that men are fortunate enough to have just behind the rectal wall, conveniently placed so you can massage it from inside the rectum. And of course, a man can experience something like intercourse if his partner thrusts into him with a suitable artificial penis. This means the man has the pleasure of erotic sensations around his anus, while his prostate is also stimulated in a way that is certainly - at the very least - pleasant. (And the whole process might just give him an idea what his partner experiences during sex.)
There are many interesting aspects to the idea of a woman getting herself a false penis and thrusting into her man. Most obvious is the physical pleasure it can give a man, even bringing him to the point of orgasm, and if not, certainly increasing immensely the intensity of his orgasm.

But this goes deeper than just pleasure.
Men who allow their women to do this are saying something like - I am secure enough in my maleness to be happy with the idea of you thrusting something up my anus and taking the dominant position. For a woman who is usually - in some sense at least - submitting to the thrusts of her man, and who wants to know how penetration feels when youre on the other end of the penis, this can be a very exciting experience, opening up new ideas about relationships, power and the roles of men and women.
Whats more, with the right sort of dildo, a woman will have a smaller protrusion in her own vagina, with the base of the strap-on pressing on her clitoral area - so she may well come from the thrusting - a novel experience for her.
OK. If you want to try it, go to the online sex shop and buy the recommended equipment: a slim silicon dildo called and a harness for your female partner to wear to go with it. Mind you, Babeland have lots of other stuff on offer as well, so you could always be adventurous and choose your own. Also, buy the video of Bend Over Boyfriend - an amusing video which is both educational and titillating - but which gives you all the information, tips and advice you need to be successful at this esoteric form of sex play.

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So much is written about arthritis and you can get confused as to what causes arthritis and what arthritis treatments are effective. Arthritis is an inflammatory condition. This inflammation comes from infections. Infections come from a variety of conditions such as:
Bacteria, viruses, pathogens, yeast that you ingest or that is already in your body
Air pollution from cars or from your work environment
Un-natural food that you eat that is processed or irradiated
Food additives such as dyes, colorings, preservatives, enhancers, gases, sugar
Contaminants in your water such as fluoride, chloride and other substances
Stress from your work and home life
This small list gives you an idea of the many chemicals and emotional sources that can lead to infections in the body and result in arthritis. You can see that all of these sources are part of your regular diet and lifestyle. Now if you couple this with a weak immune system, you set the stage for some serious arthritis conditions. A weak immune system can not control and eliminate these infections so these infections can turn into serious inflammations.
Because of toxins and infections, there are very few people that will escape developing arthritis in their life time.
But for those of you that are health conscious and look to prevent various illnesses, here are some arthritis treatments and arthritis preventive measures.
Arthritis Treatment
The first step you need to take is to take daily antioxidants. You get antioxidants in the deep dark red, blue, black berries and other fruits. Pomegranate juice is one of the most powerful antioxidant juices and provides arthritis protection. Recently I have been using Purity Products Super Reds and New Vitalitys Ruby Reds Powder. I put one scoop of powder in some apple juice or other juice and add a dropper full of green tree extract. This gives me a high dose of antioxidants to fight off the heavy dose of free radicals that I consume from the air, food, and thought. Remember free radicals attack tissue causing infections and inflammation in every part of your body.
These powders great taste and are good for the kids in the morning.
So now, if you add juicing to your morning habit, you will be adding high levels of antioxidants and in addition many minerals and vitamins that buildup your immune system. Use pineapple, alfalfa sprouts, and cantaloupe, apricot, cabbage, and cucumber juices. And, you can add a bit of ginger juice to gives you anti-inflammatory protection.
In a recent article, I wrote about Lions Mane. Here you have a powerful immune system enhancer. It contains 3 Chinese mushrooms - Lions Mane, Maitake, Reishi -that will buildup your immune system and in addition improve your memory. I have been using this for only a week and I can sense a slight improvement in my memory and how quickly words come into my thought as I express myself. Build up your immune system and this is a powerful arthritis treatment. You body will be able to fight of toxic matter and at the same time protect your joints from infection and inflammation.
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Evelyn PringleIt would be difficult to find a better career than employment as a GlaxoSmithKline attorney, especially if job security is a top priority. Not a year goes by when the company is not doling out millions of dollars to defend against charges involving corporate misconduct of one kind or another.
A limited review of the companys involvement in the legal system over just the last five years reveals a clear pattern of habitual corruption. However, although Glaxo has paid billions of dollars in accumulated fines, penalties and awards to plaintiffs in civil cases, not one company official has been arrested and charged with a crime.
Glaxos latest escapade was revealed on October 5, 2006, when Bloomberg News reported that Glaxo conducted a recall of Paxil CR, a selective serotonin reuptake inhibitor antidepressant, last month because some of the pills may lack an active ingredient, but that the company did not warn patients who may be taking the useless pills.
Doctors told Bloomberg that patients who either abruptly stop taking Paxil or get inactive pills, can face the risk of suicidal thoughts, shooting pains and flu like symptoms.
The Paxil CR pills are the highest dose sold, and can cause severe withdrawal symptoms, according to Dr Stephen Ellen, a psychiatrist from the University of Massachusetts Medical School in Worcester. If it is true that patients might have gotten dummy pills without knowing it, it is outrageous, he said.
According to Glaxo, the FDA knew about the problem and approved the limited recall plan, but FDA spokeswoman, Susan Cruzan, told Bloomberg that she did not know the details of the September Paxil CR recall.
This incident is even more outrageous because back on March 4, 2005, the government cited Glaxo for the exact same wrongdoing when the FDA and the Department of Justice initiated the seizure of Paxil CR tablets after Glaxo failed to meet the standards laid out by the FDA to ensure product safety, strength, quality and purity.
Among the violations noted then by the FDA, was the finding that the tablets could split apart and patients could receive a portion of the tablets that lacks any active ingredient, or alternatively a portion that contains active ingredient and does not have the intended controlled-release effect.
The seizures followed warrants issued by the U.S. District Courts for the District of Puerto Rico and the Eastern District of Tennessee and were executed by the U.S. Marshals Service at Glaxos Cidra, Puerto Rico manufacturing facility, its Knoxville, Tennessee distribution facility, and a Puerto Rico distribution center.
The FDA said that Glaxo had voluntarily recalled some of the affected lots of Paxil CR but had failed to recall all of the affected lots and that failure resulted in the seizures by federal authorities.
FDA and the Department of Justice will not allow drug manufacturers to ignore our high public health standards for drug manufacturing, said John Taylor, FDA Associate Commissioner for Regulatory Affairs in a statement released by the agency at the time.
Once we discover a company is not following the standards, which were created to ensure safety and quality, we expect them to correct the deficiencies in an expedited manner, Mr Taylor stated.
American consumers, he said, deserve the best health care products on the market today, and companies that are not adhering to these standards cannot assure FDA and American consumers of the quality of their products.
A month and a half later, on April 28, 2005, the FDA announced that Glaxo had signed a consent decree to correct the manufacturing deficiencies at its Cidra, Puerto Rico facility.
However, the consent decree required Glaxo to post a penal bond of $650,000,000 contingent upon either successfully reconditioning the drugs seized in March 2005, or destroying them and paying the costs to the government.
To resolve the matter, Glaxo supposedly recalled all of the lots of Paxil CR made before November 2004, and agreed to an independent quality review of the manufacturing.
But now here we are in October 2005, with Glaxo still putting patients at risk due to the exact same wrongdoing.
When it comes to civil lawsuits against Glaxo, a steady stream of cases have been filed as a result of Glaxos concealment of the known dangers associated with Paxil, including an increased risk of suicide, birth defects, violence and withdrawal syndrome.
But the companys most egregious conduct, many critics say, in light of all the serious adverse effects now linked to Paxil, was the concealment of the fact that with many patients, and especially children and adolescents, Paxil does not even work.
Glaxo has clearly put profits over patients when marketing Paxil. While concealing clinical trials that showed Paxil was ineffective and could cause children to commit suicide, according to New York state Attorney General, Elliott Spitzer, Glaxo raked in $55 million by selling Paxil to adolescents and children in 2002 alone, when more than two million prescriptions were written for pediatric patients.
The Los Angeles based Baum Hedlund law firm is handling lawsuits involving Paxil related child suicides. On March 23, 2006, the firm filed a national class action lawsuit against Glaxo on behalf of the mother of Trevor Blain, an 11-year old Kansas boy who committed suicide after being prescribed Paxil, and Tonya Brooks from Texas who attempted suicide while taking Paxil.
Trevor Blain was prescribed Paxil for separation anxiety disorder in October 2000 and he immediately began having angry outbursts and sleeping problems. However being the side effects of Paxil were not discussed with his parents, they did not realize that the troubling behavior could be linked to the drug.
Trevor continued to take Paxil until early November 2000, when he hanged himself in the family laundry room using his dogs leash. After the suicide attempt, Trevor remained in a coma until he died on December 7, 2000.
Plaintiff Tonya Brooks, age 17, was prescribed Paxil in 2004 after being diagnosed with social anxiety disorder. She too became agitated, aggressive and had sleep problems but was unaware that she might be experiencing the adverse effects from Paxil.
Tonya first attempted suicide by taking an overdose of Paxil and Ambien, a sleeping medication, and when that attempt was unsuccessful, she took a pair of scissors and gouged a hole in her leg two days later and was hospitalized for several days.
The two named plaintiffs in the case seek to represent all individuals under the age of 18 in the US who attempted suicide while taking Paxil, or the families of individuals who killed themselves while taking the drug.
The lawsuits claims against Glaxo include fraud, negligence, strict liability and breach of warranty.
The Baum Hedlund firm has been handling SSRI lawsuits since 1990, and served on the Plaintiffs Steering Committee in the first suicide related case involving Prozac, the first SSRI approved by the FDA.
Baum Hedlund partner, Karen Barth Menzies leads the firms SSRI Department and was Lead Counsel for the Plaintiffs Steering Committee in Paxil Products Liability Litigation.
Ms Menzies advocacy efforts on behalf of SSRI suicide victims have not been limited to the legal arena. She has also testified on the matter before the California State Assembly and the FDAs psychopharmacologic Drugs Advisory Committee and has met with members of Congress from both the House of Representatives and the Senate regarding the risk of SSRI induced suicidality.
The firm is also now handling Paxil birth defect litigation. On July 28, 2006, Baum Hedlund filed a lawsuit on behalf of the parents of Adrian Vasquez, who was born with life-threatening birth defects on April 19, 2004, as a result of his mother unwittingly taking Paxil during pregnancy.
Adrian was born with congenital heart defects and since eight days old, he has undergone three open heart surgeries in an attempt to repair the heart defects. He will also likely have to undergo more surgeries in the future and possibly a heart transplant at some point.
The lawsuit alleges that Glaxo, “by directly and indirectly advertising, marketing, and promoting Paxil for the treatment of women during pregnancy and by placing this drug in the stream of commerce knowing that Paxil would be prescribed to pregnant women in reliance upon the representations … that Paxil was safe and effective for the treatment of women during pregnancy and without significant risk to the fetus.”
The complaint also alleges that Glaxo “did not timely warn the medical community and consumers generally that taking Paxil during pregnancy is associated with a significant increased risk of birth defects and abnormal development of the unborn child.”
In reviewing Glaxos entanglements in the legal system over the last five years, the first guilty verdict in a Paxil-related suicide case was issued on July 7, 2001, when a jury in Cheyenne, Wyoming, ordered SmithKline Beecham (now GlaxoSmithKline) to pay $6.4 million to the relatives of Donald Schell, who after taking Paxil for only 2 days, shot and killed his wife, daughter, and granddaughter before killing himself.
At trial, the jury heard the expert testimony of British psychiatrist and SSRI researcher, Dr. David Healy, who told the panel that all SSRIs could trigger suicidal and violent behavior in some patients. On the stand, Dr Healy described his own studies that showed that SSRIs could even cause one in four healthy volunteers to become agitated, and in some cases suicidal.
Healthy volunteers means the subjects were not mentally ill to begin with.
Dr. Healy further revealed internal SmithKline documents from clinical trials conducted by the company to support his findings. He presented a summary of a study involving more than 2,000 healthy volunteers, taking either a placebo or Paxil, that found that hundreds of healthy volunteers on Paxil had experienced adverse reactions, ranging from insomnia or anxiety to attempted suicide, that doctors in the study coded as or caused by Paxil.
Glaxos defense team told the jury that taking 2 Paxil pills could not have caused Mr. Schells violent and suicidal behaviors. However, the summary of the companys own study showed that some healthy volunteers experienced anxiety, nightmares, hallucinations and other side effects coded as caused by Paxil within two days.
In as early as four days, another volunteer experienced akathisia, a severe form of agitation that experts believe increases the risk of violence and suicide, and 2 other volunteers attempted suicide after taking Paxil for 11 and 18 days.
In the end, after considering all the evidence, the jury placed 80% of the blame for the tragedy on Glaxo.
Glaxo is notorious for concealing negative information from Paxil and legal experts say civil litigation has played a major role in exposing the dangers kept hidden for so long. According to Attorney Menzies, Civil lawsuits uncover internal company documents to which not even the FDA has access.Through our Paxil litigation, she notes, ve obtained documents that show a seriously troubling mentality of profit over safety and a callous disregard for the welfare of children.s about as reprehensible as you can get, Ms Menzies says.
There is certainly enough available evidence to back up that assertion. For instance, on July 15, 2003, after meeting with the Canadian regulatory agency, Health Canada, Glaxo issued a public advisory in Canada alerting pediatric patients, their parents or guardians, and healthcare professionals that until further information was available that Paxil should not be given to pediatric patients, due to concerns of a possible increased risk of suicidal thinking, suicidal attempts or self-harm.
The advisory also said, Paxil must not be used in pediatric patients with major depressive disorder due to the additional fact that studies have failed to show that Paxil was effective in this patient population.
In addition, Glaxo distributed letters to physicians in Canada and the UK, informing them that studies had failed to demonstrate the efficacy of Paxil in the pediatric population and that there was a doubling of the rate of adverse events, including emotional lability. However, Glaxo did not provide American physicians with this information.
Instead, it sent Medical Information Letters only to those physicians who specifically requested information concerning Paxil as a treatment for children and adolescents.
Glaxo also took steps to actively conceal the negative information about Paxil from the American public. In a June 10, 2003 press release in UK, Glaxo disclosed the suicidal thinking or attempts in children, and particularly in adolescents. But the companys American press release on June 19, 2003, stated that there is no evidence that Paxil is associated with an increased risk of suicidal thinking or acts in adults and that not a single person committed suicide.
The American press release also provided no safety or efficacy information about Paxil regarding its use in the treatment of pediatric patients.
The five-year litigation history of Glaxo involves many different types of cases. For instance, in April 2003, Glaxo paid $88 million and signed one in a slew of corporate integrity agreements, to settle charges that the company overcharged the Medicaid programs for Paxil and the nasal-allergy spray, Flonase, using a complex scheme that involved the re-labeling of products sold to an HMO at deeply discounted prices, to avoid the obligation to pay millions of dollars in rebates to the Medicaid program.
The Medicaid Rebate program requires Glaxo to give Medicaid the same discounts it gives to commercial customers like HMOs, hospitals and drug store chains. Drug companies have to report their lowest discount price for each Medicaid covered drug on a quarterly basis, and then pay a rebate based on that price.
To resolve another shady deal, in a February 6, 2004 press release, Glaxo announced that it had agreed to pay $175 million to settle an antitrust class action lawsuit involving the anti-inflammatory drug Relafen filed on behalf of direct purchasers, including pharmaceutical wholesalers.
This lawsuit alleged that Glaxo used patent litigation to block generic versions of Relafen from reaching the market. Glaxo filed the patent infringement lawsuits against two generic drug makers in 1997, which triggered an automatic 30-month stay of the FDAs authority to grant approval of the generic drug applications.
However, Glaxo lost the patent litigation when U.S. District Judge ruled after a trial that Glaxo had obtained the Relafen patent through fraudulent misrepresentations to the U.S. Patent and Trademark Office.
The two generic companies, Teva Pharmaceuticals USA and Eon Labs Manufacturing Inc., later filed antitrust suits alleging that Glaxos patent lawsuits were litigation filed for the purpose of maintaining a monopoly.
In regard to these lawsuits, Glaxos Februay 6, 2004 press release said, Similar actions from other plaintiffs in the Relafen antitrust matter, including claims made by Teva, chain drug stores and Eon Labs have also been settled, resulting in further payments from GSK.
And of course the press release contained the standard claim that Glaxo continues to believe that its actions were appropriate in obtaining and enforcing its patent for Relafen.
Five months after the announcement of the settlement in the patent case, on June 2, 2004, New York State Attorney General, Eliot Spitzer, issued a press release to report the filing of a lawsuit against Glaxo for concealing information about the safety and efficacy of Paxil in treating children and adolescents.
The complaint alleged that, starting in 1998, Glaxo engaged in a concerted effort to withhold negative information concerning Paxil and misrepresented data concerning the drugs safety and efficacy when prescribed for depression in children and adolescents and pointed out that Paxil has not been approved for any condition or illness in children or adolescents.
Specifically, it said, Glaxo conducted at least five studies on the use of Paxil in children and only published and disseminated one, which showed mixed results on efficacy.

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