TRIAD - Treatment of Insomnia and Depression

Participants with major depressive disorder and insomnia who meet all study criteria will
receive state-of-the-art antidepressant medications and one of two insomnia therapies. The
specific therapy for insomnia will be determined by chance (like a flip of a coin), with an
equal chance to receive either cognitive-behavioral therapy for insomnia or desensitization
psychotherapy for insomnia. The study physician will select an initial antidepressant
medication from a list of three possible medications . If that medication is not helpful,
another medication may be tried after 8 weeks or in the event of severe side effects.

Inclusion Criteria:

1. Meets criteria for Major Depressive Disorder

2. Between 18 and 75 years of age and adequately fluent in English

3. Meets criteria for an insomnia disorder

Exclusion Criteria:

1. Women who are currently pregnant, breast-feeding, or not using a reliable birth
control method.

2. People for whom the antidepressant medication(s) provided in the study is not
indicated

3. People who have had minimum adequate trials of (or have not been able to tolerate)
all three study medications.

4. People with uncontrolled medical conditions.

5. People with moderate or severe sleep disorders other than insomnia

6. Individuals on a fixed night shift or rotating work schedule that requires a night
shift.

7. Patients with a current principal diagnosis of a psychiatric disorder that
necessitates treatment that is not offered in the study.