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*Major depressive disorder:* Adult: 60 mg once daily. *Generalized anxiety disorder:* Adult: Initially 30 mg once daily, increased if necessary to 60 mg once daily; max. 120 mg per day. *Diabetic neuropathy:* Adult: 60 mg once daily, discontinue if inadequate response after 2 months; review treatment at least every 3 months, max. dose to be given in divided doses; max. 120 mg per day. *Moderate to severe stress urinary incontinence:* Adult (female): 40 mg twice daily, patient should be assessed for benefit and tolerability after 2-4 weeks, alternatively initially 20 mg twice daily for 2 weeks, this can minimise side effects, then increased to 40 mg twice daily, the patient should be assessed for benefit and tolerability after 2-4 weeks.

Hepatic or severe renal impairment, narrow-angle glaucoma.

Cardiac disease, bleeding disorders, elderly, history of mania or seizures, hypertension (avoid if uncontrolled), raised intra-ocular pressure, susceptibility to angle-closure glaucoma, hypomania, renal impairment, concomitant use with other antidepressants, elderly, liver transaminase elevations.

Drugs metabolised by CYP2D6 (e.g. flecalnide, vinblastine, carbamazepine, tricyclic antidepressants). Potent CYP1A2 inhibitors/inducers. CNS-`active drugs e.g. diazepam, imipramine, phenytoin, haloperidol, alcohol.

Abnormal dreams, anorexia, anxiety, bruxism, decreased appetite, diarrhoea, dizziness, drowsiness, dry mouth, dyspepsia, fatigue, flatulence, headache, hot flush, insomnia, nausea, nervousness, palpitation, paraesthesia, pruritus, sexual dysfunction, sweating, tremor, visual disturbances, vomiting, weakness, weight changes, dysphagia, gastritis, stomatitis, halitosis, hepatitis, hypertension, hypothyroidism, movement disorders, muscle twitching, musculoskeletal pain, photosensitivity, postural hypotension, raised cholesterol, syncope, tachycardia, taste disturbance, thirst, urinary disorders, vertigo. Rare: Mania, angle-closure glaucoma