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Paxil doesn’t seem to be working.

Posted by ellemccope @ellemccope, Oct 2, 2025

I have been on 10 mg of Paxil for Generalized Anxiety Disorder for 3 weeks. It does not appear to be working — no noticeable change in my anxiety. I have also been experiencing daily nausea from the medication. Has anyone else had this experience? Do I need to be patient and give the Paxil more time to work?

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ellemccope | @ellemccope | Oct 16, 2025
In reply to @heyjoe415 "Wow Ellen - your kind words absolutely made my day. Than you so much! Interesting that..." + (show)
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Wow Ellen - your kind words absolutely made my day. Than you so much!

Interesting that you were on Zoloft for almost as long as I have been on Paxil. I really hope it starts to help you, and if you don't feel it at 20mg, 40 mg may just work. Here's why I say that:

Last year, for whatever reason, I started tapering down from 40mg/day under my PCP's guidance. I first dropped to 30mg (that was kind of a pain cause there isn't a 30mg pill, but a small problem). I was fine at 30mg for a month, and then dropped to 20mg.

At 20 mg I started feeling worse. Certainly not a deep depression, and no return of panic attacks, just not feeling quite right about things. I usually am pretty enthusiastic about life and I didn't feel that way. Where I used to look forward to going to the gym everyday, suddenly it became harder.

Well I went back to 40mg and I'm fine now. I hope that will be true for you.

Another thing that has helped me tremendously in dealing with depression is vigorous exercise. In my 30s and 40s (well before I took Paxil), I took up long-distance running and felt much better. My knees are no longer able to withstand that impact, so I spin 5-6x/week.

So I hope you get to a better place Ellen. 40mg seems like a good therapeutic dose for Paxil.

And if this doesn't work, don't give up. There are always new drugs being introduced. And please do update me on your progress.

All the very best to you Ellen for bright and happy days ahead! You deserve that.

Joe

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@heyjoe415 - Hi, Joe! Thank you for the very thoughtful message.
Not only am I experiencing anxiety and depression but also I don’t have interest in the things I used to enjoy. I hope once I reach a therapeutic dose of Paxil,, my desire to participate in my hobbies and activities that I’ve always loved will return.
Do you happen to recall how long your doctor took to increase your dose from 20 mg to 40 mg?

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heyjoe415 | @heyjoe415 | Oct 17, 2025
In reply to @ellemccope "@heyjoe415 - Hi, Joe! Thank you for the very thoughtful message. Not only am I experiencing..." + (show)
Profile picture for ellemccope @ellemccope

@heyjoe415 - Hi, Joe! Thank you for the very thoughtful message.
Not only am I experiencing anxiety and depression but also I don’t have interest in the things I used to enjoy. I hope once I reach a therapeutic dose of Paxil,, my desire to participate in my hobbies and activities that I’ve always loved will return.
Do you happen to recall how long your doctor took to increase your dose from 20 mg to 40 mg?

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Hi Elle, and you're very welcome. We're all in this together.

I think you may be asking how long did it take my Dr to get me to 40mg when I started taking Paxil. In my story about tapering down to 20mg, and then returning to 40mg, that was immediate and recent.

When I started taking Paxil back in 2002, I don't recall how quickly my dose was increased. And I had an almost immediate and positive reaction back in 2002, but no two people react the same to the same drug.

When my Dr was asking me questions back in 2002 about my depression, I remember telling him that I had trouble letting minor stuff roll off my back. I took everything personally. That seemed to resonate with him and he prescribed Paxil as a result, and it worked. "Depression" isn't a one-size-fits-all condition, and different drugs address different aspects of it.

You describe having no interest in things you used to enjoy. Did you mention this specifically to your Dr? I don't know if it will matter, but I would ask.

How many weeks have you been on Paxil? It can take 4-6 weeks to kick in.

One last thing, I take 100mg of Seroquel (Quietapine) everyday and have for as long as I've been on Paxil. It's classified as an "atypical antipsychotic", but can also be prescribed for other conditions. Specifically, Dr's prescribe it off-label for "mood stabilization", and it also helps me sleep, so I take it at night. It's available in doses as low as 25mg. I think it helps to keep my depression at bay, along with Paxil and regular, vigorous exercise.

Bottom line Elle, if Paxil doesn't work once you're at 40mg/day, I'd work with your Dr, or ideally a psychiatrist, to find something that does work. Paxil did it for me and still does, along with Seroquel. I'm lucky. A lot of people have to try a few drugs before finding a match.

So keep on trying. If you want to go to 40mg/day I would again ask your Dr. to prescribe it. And ask about Seroquel as a "mood stabilizer" and reference my experience. It is NOT just a drug for bipolar or psychotic episodes, although it is prescribed for them.

Depression is no fun, but it's treatable. Patience is sometimes required. And much has changed since I started taking Paxil and Seroquel over 20 years ago.

Are you also seeing a therapist regularly (once a week or so)? My therapist practices EMDR - short for "eye movement desensitization and reprocessing". I strongly advise for this type of therapy. It has helped me reconcile with some traumatic stuff in my past. You can research it. I'm an example of how well it has worked.

Keep pushing Elle and you'll find a good place. And please let me know how you progress. You will find an answer.

Joe

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