Sabrina, yes paxil,like all the other ssri's can cause weight gain. The medication that doesn't is wellbutrin, or if anxiety is the main symptom, klonopin. You should adjust to tiredness within a week, if not, then maybe the dose is too high for you. Re obesity, you have to learn how to stop stress eating, which is probably more difficult for you because of your anxiety. the best way to do that is to take the course at www.shrinkyourself.com, or consult a therapist.
General side effects are mostly present during the first 1-4 weeks while the body adapts to the drug. I am unable to find any evidence of weight gain anywhere in published information about Paxil. Just eating right and exercising should keep you fit.
Not all SSRI (like Paxil) cause weight gain for all patients. But one study suggested that there might be differences in weight gain due to the different types of SSRI. Paroxetine (Paxil) may be more likely cause a significant weight gain than other drugs of this type (like fluoxetine or sertraline). Studies about citalopram found no significant weight changes for most patients (but a minority of about 5% of the patients had a weight gain of more than 5 kg).
Now let us look at some other antidepressants:
Buproprion (Zyban) reports weight loss in the course of therapy (caused by antihistaminic effects). However, the therapeutic effect may be less than other antidepressant. Buproprion is not available in all countries.
Venlafaxine (Efexor) (inhibitor of serotonine and noradrenaline uptake); no relevant weight gain (but limited data available)
Nefazodone (Nefadar) no significant increase of weight
Mirtazapine (Rmeron) More likely than placebo to cause weight gain, less than tricyclic medication.
Tricyclic antidepressants Known for weight gain in short term and long term medication
So what are your options:
* Get appropriate education about the effects of the drugs on your weight
* Make a food diary to rule out other causes of weight gain
* Increase exercise
* Talk with your doctor about different treatment options
* switching to another SSRI
* switching to another antidepressant class
* combine your medication with Buproprion (causes appetite loss). For a small number of patients (with ADHD), the additional therapy with psychostimulants (methylphenidate) has a similar effect.