Paxil losing efficacy?

[Spike438]

I've taking 20 mg. of Paxil daily for about 5 years. Over the last couple of months , I've been experiencing extreme depression, anxiety, and loss of concentration, almost every day, and at any time. The worst part of the symptoms can last anywhere from an hour to 4 or 5 hours.Nothing major has changed in my life, my diet and exercise patterns have remained the same. Any suggestions? I've seen information indicating that Zoloft may be a good substitute, but I don't know if it helps with anxiety or concentration issues.

[Paxiled]

Before I gave up on Paxil I'd at least try a higher dose.  Paxil is very hard to stop taking, so if you decide that's the right course make sure your psychiatrist knows how to work with this med and with you -- don't let someone talk you into quitting by some general schedule, quit at your own pace and you'll be fine.  As for switching, the reason I suggest at least trying a higher dose of the Paxil is that Paxil for whatever reason is much stronger in its affinity for both serotonin and choline, and that makes it hard when you stop taking it for something else to work.  That's not hard and fast, just something to consider as you decide what to do.  If it's just tapped out for you, well, you have to move on and hope for the best, and because Zoloft is also a pretty strong med it's probably a good choice to try.  Also, if it really has stopped working, and I know this sounds odd, but that should make it easier to stop taking -- meds that don't work or no longer work can be easier to stop since they're not affecting the brain as much anymore.  

[ScalpMassager]

Paxil is reputedly extremely difficult to discontinue (slowly but surely), but if you're switching meds I anticipate that will become your next step recommended by your doctor.

Meanwhile, have you been using any self-help methods towards reducing your depression?  Such as learning Cognitive Behaviour Therapy approaches for dealing with dark thoughts, very healthy eating practices, varied physical activity (long, calming walks; brisk aerobic walking sessions), meditation, improved sleep routines, etc.?