Combining Antidepressant Medication and Psychotherapy for Insomnia to Improve Depression Outcome

Inclusion Criteria:

* Diagnosis of major depressive disorder
* HRSD(17) score of at least 14
* Presence and complaint of insomnia for at least 1 month
* Fluent in English
* Use of an effective form of contraception throughout the study

Exclusion Criteria:

* Other psychiatric disorders (e.g., bipolar disorder, post traumatic stress disorder, obsessive compulsive disorder, eating disorder)
* Psychotic symptoms
* Serious, unstable, or terminal medical condition
* Axis II diagnosis of antisocial, schizotypal, or severe borderline personality disorder
* Substance abuse
* Not willing to end other psychiatric treatment
* Previous electroconvulsive therapy or vagus nerve stimulation treatment during the last year
* Sleep apnea, restless leg, or periodic limb movement disorder (to be ruled out after first sleep study)
* Other sleep disorders
* Currently pregnant or breastfeeding
* History of seizure disorder
* Disease or condition that produces altered metabolism or hemodynamic responses
* Liver or kidney dysfunction
* Current use of any over the counter medications or herbs for mood or sleep benefits (e.g., melatonin, valerian, kava, hop extract, St. John's Wort, SAMe)