Has a chronic inflammatory autoimmune condition other than SLE.

Has an acute or uncontrolled co-morbid medical condition.

Uncontrolled narrow angle glaucoma.

Has been hospitalized in the last four months for a lupus flare.

Pregnant or breast feeding.

Has a current or prior major depressive disorder or other DSM IV diagnosis within 2 years of the screening visit.

The use of antidepressants, MAO inhibitors, antipsychotics or lithium

The use of pregabalin or milnacipran within 2-4 weeks.

Has received cyclophosphamide and or rituximab within 4 and 6 months.

Unable to speak, read, and understand English.

The Effect of Milnacipran on Fatigue and Quality of Life in Lupus Patients