brummy,
as to the interaction with paxil, there have been few if any clinical studies done on the interaction of nal with other drugs. however, anecdotally, on this board i believe there are folks who use anti-depressants who have had success with tsm.
i wouldn't worry yet. if you go back and read others early experiences some people report their response day by day at first and merlot is right there is a wide range of individual experiences. some people actually see higher numbers at first because they have "given themselves permission to drink" for the first time in a while. others have the immediate honeymoon effect.
it's easy to worry and harder to stick with it and be patient, but that is what this process requires. so, read as much as you can on the board, always take your nal 1 hour before drink, and be ready for a possibly long and bumpy road. your tsm journey may be short and smooth, but i think it's better to be prepared for all possibilities.
best to you!
path