OBJECTIVE: Paroxetine is a potent selective serotonin reuptake inhibitor with antidepressant and anxiolytic activity that is effective in the treatment of generalized anxiety disorder (GAD), improving the core symptoms of anxiety, worry, and tension. The majority of patients with GAD have chronic symptomatology and significant comorbid mood and anxiety disorders that often require ongoing pharmacotherapy. This article reviews the efficacy and tolerability of paroxetine in the short- and long-term treatment of GAD including remission data. DATA SOURCES: Data from more than 1800 outpatients with DSM-IV-defined GAD were analyzed from 3 short-term (8-week) studies and a longer (6-month) relapse prevention study. These studies were all randomized, double-blind, placebo-controlled trials of paroxetine. DATA SYNTHESIS: The results emphasize the benefit of paroxetine treatment in GAD, enabling a substantial proportion of patients to achieve clinical remission and preventing relapse. Long-term treatment with paroxetine also shows good tolerability with no evidence of weight gain. CONCLUSION: Given the high comorbidity of psychiatric depression and anxiety, the long-term efficacy and tolerability of paroxetine are important considerations when selecting a first-line therapy for patients with GAD.