Q:  Klonopin & Moclobemide

Dear Dr. Phelps,

I've heard doctors say that while Klonopin may help with anxiety it can make the big picture worse in mood disorders.  Is there any truth to this?  What's your opinion?  I suffer from a Bipolar Spectrum Disorder + Social Phobia, among other things.  I'm currently taking Geodon and we will soon be adding moclobemide for SP, but I'm also interested in Klonopin.  Any thoughts?

Thanks,
Jon


Hello Jon -- 
A few: first, I'd strongly recommend looking at the CBT approach to social phobia as opposed to moclobemide, which if you do indeed have a bipolar variant runs the risk of making things worse -- especially as Geodon has not really proven it's mood stabilizer capacity yet (and so far I rather doubt it has much).  

Klonopin can make things worse through just being too much of a wet blanket, in my experience; but I've not heard of any way in which it could fundamentally worsen things.  People talk about how theoretically, like all benzodiazepines, it could contribute to depression; that's a very theoretical concern, compared to our actual experience with it. 

Dr. Phelps