What medications can be taken for chronic anxiety and depression?

Hello doctor,

I am a 52-year-old and I suffer from anxiety and depression. I have been on Paroxetine for over 20 years. About 8 years ago it stopped working and I tried other SSRIs and SNRIs but they did not work so I went back to Paxil and it eventually worked again, which I took for a while. I live in a country where they do not prescribe benzos. My main symptoms of anxiety are anticipatory anxiety where I get nausea, diarrhea, and lack of appetite for many days ahead of a social or work event. Even something as little as going for lunch with friends, etc. It was well under control up until the last two years and it has been getting much worse, and I get very low mood as well. I went from 20 mg to 30 mg of Paxil about six months ago, but it did not help. I will upload my paramagnetic profile. I cannot use some medications or should not because of it like Effexor, etc. I would say I am obsessive but not compulsive and may have a bit of ADHD as well. My question is what medications should ask my doctor to prescribe for me? I have been told to increase the dosage of Paxil to 40 mg but in the past, it did not help and made me feel worse when I did that. So I am reluctant to try, but open to it if you strongly advise. My pharmacogenetic profile may be the reason why higher doses do not work. We do not have Paxil CR in the country where I live but I could try and source from overseas if you feel that would be better. For situational anxiety, I tried the beta blocker Propanol but it gave me diarrhea.

Hello doctor,

I meditate every day and yet that does not help. What is JPMR? If I cannot get the CR version do you feel an increase to 40 mg would help or what alternative or adjunct medicine would you recommend?