 Patients will be rated for improvement at weeks 3, 6, and 9 for possible dosage adjustment. The determination of medication adjustment will be made based upon scores on the Clinical Global Improvement Scale given to the participant at these time points see Table 2. Dosage adjustment will be considered if the clinician rates the patient as a score of 3 or higher on this scale Minimally Improved to Very Much Worse. However, the CGI Efficacy Index for drug effect will determine the direction of dosage adjustment. A side effect that is rated as significantly interfering with patient functioning or outweighing therapeutic effect will result in one or more of the following courses of action: 1 addition of concomitant medication, 2 decrease in the study agent dose, 3 discontinuation of the study agent. In other words, a patient who is scored as 3 or higher on the CGI Global Improvement Scale who does not have significant side effects on the CGI Efficacy Index will have the study agent dose increased. Any patient who experiences significant side effects at any time during the treatment period will be considered for dose decrease, discontinuation or concomitant medication use. A decision regarding the proper course of action will be dependent on the severity of the side effect, overall therapeutic effect and patient input. 