Therapy for Depression With Co-occurring Panic or Anxiety Symptoms

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.