Doc says it's a side effect of the Paxil. We have reduced my dose to 10mg a day and I am taking 1mg of slow release alprazolam a day until the anxiety eases off. I recently moved town so the stress of moving and changing climate and lifestyle has also played a role. Once I am done with my pack of Paxil we'll resume 20mg a day and see if the twitching resumes or if it was just a passing thing.