• Linear measure of global benefit-risk assessment. Benefit is defined as remission at endpoint (HMAD17 total score less than or equal to 7, a virtually symptom-free state.
  

• HAMD17 Response Rates: Response is defined as a greater or equal to 50% reduction in HAMD17 total score from baseline to endpoint.
  
• HAMD17 Time to First Response: Time to first response is defined as the visit where a sustained greater than or equal to 30% reduction in the Maier subscale of the HAMD17.
  
• HAMD17 Remission Rates: Remission is defined as a HAMD17 total score of less than or equal to 7 at endpoint.
  
• Hamilton Anxiety Rating Scale (HAMA) that measures the presence and severity of anxiety. The 14-item version of this scale will be used to assess the severity of anxiety and its improvement during the course of therapy.
  
• Clinical Global Impressions of Severity (CGI-Severity) Scale to record the severity of illness at the time of assessment.
  
• Patient's Global Impressions of Improvement (PGI Improvement) Scale is a patient-rated instrument that measures the improvement of the patient's symptoms.
  
• HAMD17 Subscales to evaluate severity of psychic and somatic manifestations of anxiety, as well as agitation; evaluate dysfunction in mood, work, and sexual activity, as well as overall motor retardation; evaluate initial, middle and late insomnia.
  

Inclusion Criteria:

• must be at least 18 years of age
• must be diagnosed with depression
• must sign informed consent

Exclusion Criteria:

• women who can become pregnant must be using birth control
• previous diagnosis of bipolar disorder, schizophrenia, or other psychotic disorder
• history of substance abuse or dependence in the last year
• patients who are suicidal
• frequent or severe allergic reactions with multiple medications