BUT No matter what he just can not orgasm. It makes it hard on him as well as us. He is afraid it could be something serious at times and at other times he is thinking it is just the meds he is on for high BP and then paxil. Any ideas here?

I have no expertise in this area but here is some info and if you scroll down far enough it talks aout uro-genital effects:
Paxil (Paroxetine Hydrochloride) Drug Information: Uses, Side Effects, Drug Interactions and Warnings at RxList