Used primarily in the treatment of major depressive disorder, particularly in patients exhibiting agitation or anxiety. It is effective for both endogenous and reactive depression. Due to its tetracyclic structure, it offers an alternative for patients who do not tolerate tricyclic antidepressants. Also used off-label for managing neuropathic pain and as a sedative in certain anxiety-related conditions. Its noradrenergic activity contributes to improved mood and energy levels in depressed individuals.