Keep in mind that Tramadol is very slow to act and give results.

It has to be absorbed by the liver first and converted to its active form. This takes time and will be delayed by the presence of food.

Some people lack the liver enzyme to activate tramadol, and for those people there will be little or no response.

This slow to give results sometimes leads people to increase that dose prematurely and if they take extra, there will be a sudden high response when it is metabolized/converted, and hence increased side effects.

Thanks everyone for the replies
 

The length of time you have been on Paxil is not a factor for the interaction with Tramadol.

They both increase serotonin and can lead to serotonin syndrome.

Using it every day may lead to tolerance with it. And some people do become habituated to it over time, so a slow taper is needed if you take it every day or frequently when you decide to stop.

Tramadol is thought to be better for nerve pain, than opiates by some doctors/experts too. If you search for "opiates for nerve pain" you may come across some discussions on the preference for tramadol. It is recommended for patients with fibromyalgia pain for example.

Also you have to avoid using DM in cough and cold products OTC... DM will increase serotonin in people using serotonergic drugs like Paxil and tramadol.