 Treatment seeking adolescent patients with a moderate to severe major depressive episode defined as a 40 or greater on Childhood Depression Rating Scale-Revised CDRS-R will be invited to participate in this study evaluating the GeneSight platform. This new technology can rapidly assess PK and PD genetic variation that can potentially impact antidepressant, anti-psychotic, and stimulant treatment selection. These patients will have GeneSight testing and will be randomized to one of two groups. In Group 1 n138, GeneSight testing results will be available to the patients treating clinician prior to treatment selection. In Group 2 n138, testing results will not be available to the patients research treating clinician. However, all testing results will be made available to all participants and clinicians after the 8-week trial upon completion of blinded assessments at week 8. The patients and the clinical raters will be blinded to group assignment. 