Antidepressants of all varieties represent a common form of therapy for many chronic states including fibromyalgia. The majority of antidepressants increase the levels of serotonin or norepinephrine in the central nervous system. Milnacipran is a dual norepinephrine and serotonin reuptake inhibitor and may be effective in the treatment of fibromyalgia.

Inclusion Criteria:

• Diagnosis of fibromyalgia defined by 1990 American College of Rheumatology (ACR) Criteria

Exclusion Criteria:

• Psychiatric illness
• Depression
• Suicidal risk
• Substance abuse
• Pulmonary dysfunction
• Renal impairment
• Active cardiac disease
• Liver disease
• Autoimmune disease
• Cancer
• Sleep apnea
• Inflammatory bowel disease