SSRI's and anxiety

I have situational panic attacks, and I have been presribed Xanax which I know is highly addictive.  I have also tried Celexa, and at one point this made the anxiety (and insomnia) much more acute. I have also used it for depression, and had positive results (except for the usual side-effects of sleeping all the time, being totally apathetic and disinterested in doing any work, sexual problems, and horrible nightmares -- this is not usually listed as a side effect, but my Doctor told me that he has heard of this before).  He has prescribed me Paxil in addition to the Xanax (he only agreed to the Xanax because I hate anti-depressants with a passion).  I agreed to try the Paxil as well. My concern is that it is imperative that I be functioning at high speed right now (this will end by February as the situation will end), and I do not need to be sleeping or apathetic .... and I'm terrified that one of the side effects of Paxil is also increased anxiety, heart-rate, blood pressure etc  -- I can't take any increase of that right now. Do you have any advice for me (both about the possibility of increased anxiety in the short-term and about nightmares associated with either Celexa or Paxil)?
Thanks for letting me ask, and sorry it is so long.

[Roger Gould, M.D.]

all of the antidepressants you mentioned can have all of these same side effects, and it is hard to predict from medication to medication...often people have opposite of the expected effect and change to the next one and it works just fine.  If you do take Paxil, be careful about getting off of it or start with the sustained release tablets for a trial to make sure you don't have undesirable side effects.

Also, ask your doctor about Buspar as an alternative anti-anxiety medication without any of these side effects.

You might also consider some online counseling at my site..www.masteringstress.com to help you master the panic attacks on a more conscious, systematic basis along with the medication.