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

• Meets criteria for Major Depressive Disorder
• Between 18 and 75 years of age and adequately fluent in English
• Meets criteria for an insomnia disorder

Exclusion criteria

• Women who are currently pregnant, breast-feeding, or not using a reliable birth control method.
• People for whom the antidepressant medication(s) provided in the study is not indicated
• People who have had minimum adequate trials of (or have not been able to tolerate) all three study medications.
• People with uncontrolled medical conditions.
• People with moderate or severe sleep disorders other than insomnia
• Individuals on a fixed night shift or rotating work schedule that requires a night shift.
• Patients with a current principal diagnosis of a psychiatric disorder that necessitates treatment that is not offered in the study.