Hi Misty, glad to hear you have been doing well.
2 things to consider here.
1) You have decreased your dose by 5mg from 25mg to 20mg. Paxil is
a strong drug and 5mg is a noticeable amount. The doseage
adjustment may be having some effect. This should smooth out after
around 10 days. You may find that 20mg isnt enough, then again you
might be fine due to the wellbutrin.
2) CR vs non-CR. These drugs do work differently (I am assuming the
generic brand is not controlled release). CR works by maintaining a
consistent, slightly lower dose throughout your body over the dosing
period (say 24 hrs or whatever). Non-CR builds up quickly, peaks, and
then gradually reduces its level over the half life period, at which time
its level is half the level when you first took it. Normally another dose
is taken at that time, say 24 hrs. As you have half the previous dosage
still in your system, the new full dose tops you up, and your dose will
tend to remain higher for longer. This is why repeated dosing of non-
cr drugs tends to even out after a while.
To give an example, on the CR you might have 90% effectiveness all the
time. With the non-CR, this will be 100% for the first few hrs, then it
will gradually drop to 50% over the half life period. With repeated
dosing, this will probably go up to 110% or something for a couple of
hrs, and settle at maybe 75-80% at the end of the half life period.
So as you can see, they tend to work a little differently. With non-cr
your dosage at 3am is probably higher than what you were used to on
cr, but it will drop a little lower during the day. Eventually, after say 7
-10 days this will stabilise, which is what they call the "period to reach
a stable state".
So you really have 2 options. Wait it out and see if it gets better, or
talk to your dr about changing the dosage or changing to another ssri
(or back to the CR).
Note that studies have shown that generic brands are not always
exactly the same as the brand name, so this can create some
inconsistencies also.