17 yr old daughter - diagnosis: Down Syndrome, OCD, PMDD, ADHD. Recently started Paxil, first 10mg for 4 weeks, nothing, then 20mg, nothing, then 30 mg, 4 weeks, noticed some improvement, 3 weeks ago started 40 mg, don't know if her extreme anger a d irritability the last 2 weeks is related. It can be difficult for her to express what she is feeling. Any thoughts? Calling the doc tomorrow