Rosh Internal Medicine Boost Practice Exam

What medication is commonly prescribed to a patient with fibromyalgia experiencing persistent diffuse pain?

1. Amitriptyline

2. Carisoprodol

3. Celecoxib

4. Prednisone

The correct answer is: Amitriptyline

Amitriptyline is commonly prescribed for patients with fibromyalgia who experience persistent diffuse pain due to its effectiveness in managing chronic pain and improving sleep. As a tricyclic antidepressant, amitriptyline works by modifying neurotransmitter levels in the brain, particularly increasing serotonin and norepinephrine, which can help alleviate pain and enhance mood. This dual action makes it an appropriate choice for fibromyalgia, where pain is often accompanied by sleep disturbances and emotional symptoms. In the context of fibromyalgia, several other medications may be considered, but they do not have the same breadth of effectiveness. Carisoprodol is a muscle relaxant that may be used for muscle spasms but does not directly address the broad pain symptoms associated with fibromyalgia. Celecoxib is a nonsteroidal anti-inflammatory drug (NSAID) that may be beneficial for certain inflammatory conditions but is not specifically indicated for fibromyalgia pain. Prednisone, a corticosteroid, is used to reduce inflammation in autoimmune conditions but is not a first-line treatment for fibromyalgia and may have significant side effects if used long-term. Thus, amitriptyline remains the preferred choice among the options given for managing persistent diffuse pain in fibromyalgia.