Duloxetine is another choice in the growing list of marketed antidepressants. Trials comparing duloxetine with appropriate doses of comparators are lacking. Direct evidence of a long-term benefit is also lacking. Duloxetine is a novel choice for the treatment of stress urinary incontinence, but comparative trials demonstrating its effectiveness relative to other agents are lacking. The high incidence of treatment withdrawal due to nausea may limit the use of duloxetine in practice.