Used primarily as an antidepressant in the treatment of major depressive disorder. It functions by modulating serotonin and norepinephrine activity in the brain, offering an alternative for patients who do not respond to first-line treatments like SSRIs. Its use has declined in some regions due to concerns about rare but serious liver toxicity, leading to withdrawal or restricted availability in certain markets. Still, it may be prescribed when other antidepressants are ineffective, particularly in cases involving anxiety symptoms or insomnia, as it has sedative properties. Not commonly used in elderly populations due to risk of side effects such as dizziness and hypotension.