Antidepressants: amitriptyline uses: practice question

A Pharmacology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pharmacology · Antidepressants: amitriptyline uses

Sample item

A 50-year-old man with painful diabetic neuropathy and difficulty sleeping is started on a low dose at night of an antidepressant that also helps migraine prophylaxis. Which is it?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Amitriptyline

Amitriptyline is a tricyclic whose analgesic effect on neuropathic pain occurs at doses lower than needed for depression, and it helps migraine prophylaxis and nocturnal enuresis. Anticholinergic and cardiac effects limit use in the elderly.

Option by option

  • A. Bupropion

    Bupropion is not used for neuropathic pain.

  • B. Fluoxetine

    Fluoxetine has little analgesic effect.

  • C. Amitriptyline (correct)

    Correct. Tricyclics are first-line for neuropathic pain.

  • D. Mirtazapine

    Mirtazapine is not an established neuropathic pain drug.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pharmacology question

What is the answer to this Pharmacology question?

The best answer is C, Amitriptyline. Amitriptyline is a tricyclic whose analgesic effect on neuropathic pain occurs at doses lower than needed for depression, and it helps migraine prophylaxis and nocturnal enuresis.

Why is "Bupropion" not the answer?

Bupropion is not used for neuropathic pain.

Why is "Fluoxetine" not the answer?

Fluoxetine has little analgesic effect.

Why is "Mirtazapine" not the answer?

Mirtazapine is not an established neuropathic pain drug.

What concept does this question test?

It tests Antidepressants: amitriptyline uses in Pharmacology. Anticholinergic and cardiac effects limit use in the elderly.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Antidepressants: amitriptyline uses?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.