I have been taking Paxil for 10 years. At first I started taking it because I had anxiety problems while eating. As soon as I started paxil these problems went away for the most part in a few weeks. A couple years later I started having panic attacks. I recently began seeing a psychiatrist who increased my dosage gradually from 20mg to 60mg. I really haven't noticed any difference though at all when going from 20mg to 60mg of paxil. He also prescribed 1mg of Ativan, which I only take when needed (about twice a week). I was either going to ask him to decrease the dose of Paxil or try a different medicine. One therapist told me that after a few years your body chemistry changes and a medicine such as Paxil may no longer be effective. I just don't see the point in taking 60mg when 20mg seemed to do the same thing. Neither really helps with the panic attacks though. The Ativan does help with that, but I don't like to take it too often because it makes me tired. Do you think asking my doctor to switch to Zoloft or another medicine would be a wise choice? Also, could you recommend a good alternative to Paxil that would work well for Anxiety and Panic attacks. I don't have problems with depression.