I have been taking Paxil 20mg for about 10 years. It appears to have stopped working. There appears to be a phenomenon called “poop out” (seriously, google it) where ssris stop working after a time. It does not seem to be completely understood and responses to it vary widely. I would like to know if this has happened to you and what you and your doctor did about it. I will of course ask my own doctor (which is not you).
I just wanted to say good luck to you. It might be as simple as upping the dosage, or possibly switching to a different SSRI.
I’m sorry to hear that. 
Maybe switch to another one? I have nothing of value to add as I too took Paxil 20 mg for about 10 years and I never experienced it not working. I actually switched to Zoloft after 10 yrs of taking it, when I got pregnant, and it works almost as well.
I’m beginning to wonder if I’m having poop-out with Celexa. I was taking it w/ Wellbutrin, stopped both, went back on the Wellbutrin, then after several months went back on the Celexa. The first few months with the Celexa were great. Now, not so much. I tried upping the dose but it didn’t seem to make a difference. I’m hoping that part of it is SAD, and when the days get a little longer (it’s the darkness in the morning that seems to do me in), my mood will improve.
Paxil is now being made by a different company from the one that developed it. It’s actually a generic, although at name-brand prices. I noticed a definite difference and my doctor simply increased the dose.
I’d suggest discussing this with whoever prescribed it for you, except that you already said you are going to do that, so I don’t need to suggest it.
Paxil was the first anti-depressant I ever took when I was 18. I’ve been on more than a dozen different ones in the 20 years that followed…
The most effective of all the meds I’ve tried was Paxil CR. If regular Paxil has been effective for you for such a long time, I would suggest trying Paxil CR next. It is a controlled release version of Paxil and actually is quite a different drug overall despite sharing the Paxil name. Side effects are minimal and, if it works for you, it tends to work very well and building a tolerance takes a very long time!
The other venue that I would check out is a newer class of drugs called SNRIs (Serotonin–norepinephrine reuptake inhibitors). They have an even lower potential for side-effects and, if there are any, they are usually very mild. THe drugs that fall into the SNRI classifcation are- Effexor, Cymbalta, Pristiq and Meridia. Effexor is probably one the most effective anti-depressants in the history of psychological meds! I have seen it make some amazing and profound changes in the lives of a few people that I love. One word of caution- sudden discontinuation of an SNRI is literally like Hell on Earth! Don’t stop taking it, don’t miss a dose by more than 4-6 hours each day…trust me!
I’ve been dealing with this for more than 20 years. Everything eventually poops out on me. In my case, it’s referred to as “treatment resistant depression” and probably every 3 years I get to start all over to try to find a new med or combination of meds. It’s frustrating but not uncommon.