May 2014

Cancer J. 2014 Jan-Feb;20(1):8-14

A Randomized, Double-blind, 2-Period, Placebo-Controlled Crossover Trial of a Sustained-Release Methylphenidate in the Treatment of Fatigue in Cancer Patients

Escalante CP, Meyers C, Reuben JM, Wang X, Qiao W, Manzullo E, Alvarez RH, Morrow PK,Gonzalez-Angulo AM, Wang XS, Mendoza T, Liu W, Holmes H, Hwang J, Pisters K, Overman M, Cleeland C

In this randomised placebo controlled trial of cancer-related fatigue, 33 patients with breast cancer received 18 mg sustained-release methylphenidate or placebo once daily for 2 weeks and were then crossed over to the other treatment arm for a further 2 weeks. The mean age was 58 (range, 32-79), 30% had metastasis, 82% were receiving chemotherapy, 9% hormonal therapy, and 9% were receiving both chemotherapy and hormonal therapy. The mean baseline Brief Fatigue Inventory score was 5.7 (range 4.1-8.6) representing moderate fatigue. Methylphenidate improved verbal learning, memory, visual perception, analysis and scanning speed. There was however no effect of methylphenidate on patients’ worst level of fatigue or other symptoms, but patients taking methylphenidate worked more hours. At the end of the study two thirds of patients reportedimprovement in their fatigue from methylphenidate, and over half wanted to continue treatment. Methylphenidate was well tolerated with no serious adverse events.

Prepared by Jason Boland