American Board of Internal Medicine (ABIM) Certification Practice Exam

What class of medications is primarily used for depression in patients with multiple sclerosis?

1. Mood stabilizers

2. Antidepressants

3. Beta-blockers

4. Stimulants

The correct answer is: Antidepressants

Antidepressants are the primary class of medications utilized for managing depression in patients with multiple sclerosis (MS). This choice is supported by the understanding that individuals with MS commonly experience mood disorders, including depression, due to various factors like the disease's physiological effects, social isolation, and the impact of chronic illness. Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are often prescribed because they have been shown to alleviate depressive symptoms effectively. These medications can positively influence mood and also help manage certain aspects of fatigue and cognitive disturbances commonly associated with MS. In contrast, other classes of medications are not typically indicated for the treatment of depression in these patients. Mood stabilizers are primarily used for bipolar disorder and conditions involving mood instability rather than straightforward depression. Beta-blockers are mainly utilized for cardiovascular issues and are not effective for treating mood disorders. Stimulants can occasionally be used for fatigue or attention deficits but do not directly address depression. In summary, the efficacy and common practice of prescribing antidepressants make them the most appropriate choice for addressing depression in patients with multiple sclerosis.