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The year 2012 will see the production of the 18th issue of Current Pharmaceutical Design. CPD was launched in 1996 and published 40 articles that year and 40 articles the next. In the last two years completed at the time of this writing (2009 and 2010), CPD published 766 articles, a nearly 10 fold increase. It is interesting to compare the world of CPD in 1996-7 to that of 2009-10 as a microcosm of the changes that have occurred in pharmacology and the pharmaceutical sciences at large. Only 8 countries were represented in the first two years of publication with 67% of articles coming from the US, 6.2 % from Canada, 11.2 % from England, France, Germany, and the Netherlands, and 2.5% from Japan and 2.5% from Korea. For 2009-20, authors were from 49 countries. Among the top 10 were the USA (22.8%), the EU countries of Italy, England, Germany, Spain, Greece, France, and The Netherlands (60.8%), Japan (4.6%) and Australia (4.2%). Peoples Republic of China was number 11 at 3.26%. The topics as based on the top 10 most cited papers from these two sets of years is also revealing about the new trends in the pharmaceutical literature. Purinergics are still with us as are antibiotics, anti-cancer drugs, and drugs related to metabolic syndrome. But a distinct shift from small molecules to probiotics and biologicals has occurred.