NURS 6501: Final Exam: Please contact Assignment Samurai for help with NURS 6501: Final Exam or any other assignment. Email: assignmentsamurai@gmail.com   For patients experiencing frequent episodic or chronic tension-type headaches (TTH) who prefer medication to behavioral therapy, which drug is recommended as a prophylactic treatment? Group of answer choices

• Amitriptyline
• Sumatriptan
• Acetaminophen
• Ibuprofen

  The correct answer is: Amitriptyline   Explanation: For prophylactic (preventive) treatment of frequent episodic or chronic tension-type headaches (TTH), the first-line pharmacological option is:

• Amitriptyline (a tricyclic antidepressant, TCA).

Key Points About Amitriptyline for TTH:

1. Mechanism:
   • Modulates central pain pathways (serotonin/norepinephrine reuptake inhibition).
   • Reduces headache frequency and severity (not just acute relief).
2. Dosing:
   • Low doses (e.g., 10–75 mg nightly) are typically effective.
3. Evidence:
   • Supported by guidelines (e.g., AAN, ICHD-3) as first-line prophylaxis.

Why Not the Others?

• Sumatriptan: A 5-HT1B/1D agonist for acute migraine attacks (not TTH prophylaxis).
• Acetaminophen/Ibuprofen: Used for acute pain relief in TTH but not preventive therapy (risk of medication-overuse headache).

Non-Pharmacologic Alternatives:

• Behavioral therapy (e.g., relaxation training, biofeedback) is equally effective but may not be preferred by all patients.

Thus, amitriptyline is the recommended prophylactic drug for TTH.