Inclusion Criteria:

• DSM-IV diagnosis of major depression with co-existing panic or anxiety symptoms.

Exclusion Criteria:

• History of manic episode(s). Patients who have had hypomanic episodes in the past will be accepted into the study, provided they meet other admission criteria and are not presenting in a current hypomanic or mixed episode.
• History of schizophrenia or schizoaffective disorder.
• Organic affective syndrome.
• Unspecified functional psychosis.
• Anorexia nervosa or bulimia nervosa. Patients meeting criteria for an eating disorder not otherwise specified will not be excluded.
• Chronic drug or alcohol abuse/dependence within the past 2 years. Patients with abuse related to episodes will not be excluded.
• DSM-IV criteria for borderline or antisocial personality disorder. Patients who meet criteria for other Axis II disorders will not be excluded.
• Inpatient treatment due to suicide risk or psychotic symptoms.
• Index episode secondary to the effect of medically prescribed drugs.
• Significant or untreated medical illness, including cardiovascular disorder, renal or liver disease, epilepsy, untreated hypertension, or unstabilized endocrine disease.
• Medical illness that would interfere with the best treatment strategy for the potential participant.
• Current treatment with an antidepressant. Patients on a stable dose of anxiolytics for at least 3 months prior to study participation who are able to maintain this dosage throughout the study will not be excluded.
• Pregnant and breast-feeding women will be accepted into the study, but will not be prescribed adjunctive medications.