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Recent studies suggest an increased risk of Paxil birth defects for pregnant women during their first trimester. Paxil is safe and effective for long-term use and is well tolerated. Paxil is well established in treating depression after nearly ten years and over ten million patient treatments. Zoloft, Paxil, Luvox and Prozac are currently used by more than five million Americans. Paxil works by helping to restore the balance of certain natural chemicals in the brain.