Organon International and Meiji Seika have filed an application for approval of mirtazapine in Japan, a drug on the market in many Western countries since 1994. Meiji Seika is commercializing mirtrazapine(brand name Reflex) in Japan which was approved for depression in 2009. SNRI Duloxetine "(Cymbalta" - Shionogi and Eli Lilly Japan) was first approved in Japan in 2010 for major depressive disorder. In the following years it gained approval for diabetic neuropathy pain, fibromyalgia, chronic low back pain and osteoarthritis. Citalopram (Lundbeck), an SSRI on the market since the late 1980s is not available in Japan, however on April 22, 2011 escitalopram (the S-isomer enantiomer of citalopram), was approved for use. There is little news, however, on the status of bupropion (Glaxo Smith-Kline), used widely in Western countries since the early 1990s and long in clinical trials in Japan. More current data shows the three most sold antidepressants in Japan in 2017 were duloxetine, mirtazapine, and escitalopram (Lexapro). Takeda and Lundbeck submitted vortioxetine (Trintellix) to the Ministry of Health, Labour and Welfare in Japan. If approved it may be commercialized in 2019.