I've been on Emsam for 9 years. It works really well for me. I did have anxiety at first and managed it with PRNs for a month or so and then it got easier and now it doesn't cause any anxiety at all although I do still take a lot of meds for anxiety but I don't think it is Emsam related since it doesn't change with dose.

I was left on 6 mg when I left the hospital after starting it and they suggested I stay on 6 mg for a month. My pdoc was off for a medical issue and my family dr agreed to increase to 9 mg at 2 weeks or so. 9 mg is the most effective dose for me although I go up to 12 if I get depressed and down to as low as 4.5 (by cutting the patches; it says not to but it works fine for me) if manic.

Did you go completely off the Paxil and then do the 2 week waiting period? I went on it IP so I didn't have to do that; I tapered down to none but skipped the waiting period b/c I was dangerously depressed. I think that regardless you need to give it time as it is a huge change. If you did the waiting period your body has been through even more and may need even more time.

If you have questions feel free to PM me or ask on this thread. I've got plenty of experience by now.