The combined treatment with valdoxan and amitriptyline has been suggested as one of the possible variants to overcome treatment resistance in somatized depression. A study design was based on the rhythmological model of depression which clinically characterized by altered sleep-awakeness cycles. According to this notion, 36 patients were divided into two groups by the presence (20 patients) or absence (16 patients) of severe sleep disorders. The combined treatment was more effective in the first group of patients with insomnia which was an indicator of altered sleep-awakeness cycles.