American Board of Family Medicine (ABFM) Practice Exam

What is considered the most effective medication for treating fibromyalgia?

1. SSRIs

2. TCAs

3. Opioids

4. NSAIDs

The correct answer is: TCAs

The most effective medication for treating fibromyalgia is the use of tricyclic antidepressants (TCAs). TCAs, such as amitriptyline, have been shown to help alleviate the widespread pain associated with fibromyalgia, as well as improve sleep quality, which is often disrupted in patients with this condition. These medications work by modulating neurotransmitter levels, particularly serotonin and norepinephrine, which are believed to play a role in the perception of pain. In addition to their analgesic effects, TCAs can also enhance overall functioning and quality of life for patients. They are typically used at low doses for fibromyalgia, focusing on their pain-relieving properties rather than their antidepressant effects. Other treatment options like SSRIs, while potentially beneficial in managing associated depressive symptoms, have not demonstrated the same effectiveness in pain relief as TCAs. Opioids are generally not recommended for fibromyalgia treatment due to potential for dependency and limited efficacy. NSAIDs may not be effective since fibromyalgia is not primarily a condition associated with inflammatory processes. Thus, TCAs stand out as the most effective choice for managing fibromyalgia symptoms.