I am so sorry to hear of your son's struggles. Hope we can help.

The common med for PCS is Elavil (amitriptyline) in small doses (10mgs or so). I don't know if it can be taken with Paxil and Xanex. Xanex is a benzodiazepine (benzo). They can be brutal. I was on one ( Klonopin) for too long. Paxil at 60 mgs per day takes care of most of my anxiety issues which appear to be related to my prior concussion history.

Does he have any history of concussions? His depression/anxiety can be from prior concussions in a cumulative fashion.

Does he have access to a Physical Medicine and Rehabilitation specialist? Headaches are common with more severe TBI. Maybe a PM&R doc can help. They are usually affiliated with a Rehab Hospital/clinic. The garden variety neuro and GP's are of little help in most cases of PCS.

How is his diet? He should be avoiding all but maybe a single serving per day of caffeine. Caffeine and Benzos are a bad mix. MSG can also make headaches worse.

There is a good resource at http://www.drakecenter.com/file.axd?...vivalGuide.pdf Download and print it out. You can also read it chapter by chapter online at www.tbiguide.com His wife needs to read it as well as anyone who is in regular contact with him.

It will also be good to connect with a brain injury support group. The Brain Injury Association of America has state affiliates who list support groups. If you are outside the US, there usually are similar organizations.

Do a search for past posts about nutrition. He needs to get very serious about B vitamins, D-3, Omega-3's and Folic acid, etc. The prior posts will have lots to read. The injured and depressed brain is in need of serious extra nutrition.

Has he sought help from a sleep specialist? His lack of sleep is likely a big cause of his headaches. He needs good sleep. I am surprised the Xanax and Paxil are not causing him to sleep. Both have serious somnolence side-effects.

I do some of my best sleeping in an easy (recliner) chair. It helps if I have the proper sounds to occupy that part of my brain. I need to have soft and comfortable feelings for all of my tactile senses. For me, that means cotton pajamas and possibly a fleece blanket for my hands. The anxiety ridden brain needs all odd sensations removed.

If he feels fidgety when he tries to sleep, then solving these tactile senses may help. I also take Neurontin (gabapentin) to help my mind and body settle down so I can sleep. Most people tolerate Neurontin very well. It works with the GABA system in the brain.

If you have specific questions, feel free to post them.

It will help if you break up your posts into five or six line paragraphs. Many of us struggle to read long paragraphs. I pasted your post into MSWord and added paragraph spacing so I could read it and respond.

My best to you and your son.