Bruera, E., Driver, L., Barnes, E. A., Willey, J., Shen, L., Palmer, J. L., . . . Escalante C. (2003). Patient-controlled methylphenidate for the management of fatigue in patients with advanced cancer: a preliminary report. Journal of Clinical Oncology, 21, 4439–4443.
The study involved patient-controlled administration of immediate-release methylphenidate 5 to 20 mg per day, taken as often as every two hours based on the hypothesis that treatment with a psychostimulant (methylphenidate) would reduce perceived fatigue.
Patients were recruited from a palliative care outpatient clinic or a pain clinic of a large university cancer center.
Unspecified
The study used a single-center pilot study prospective, open-label design; no comparison group was included.
Of the patients, 93% (n = 28) reported improvements in fatigue from baseline to day 7 of study participation (as measured by the fatigue item on the ESAS and FACIT-F). Of the patients, 93% took three or more methylphenidate tablets daily. All patients chose to continue methylphenidate for at least four weeks beyond the initial study period of seven days. The following side effects were reported by two or less participants: restlessness, dizziness, anorexia, skin rash, and self-limited vertigo and tachycardia.
No special training is required to deliver the intervention; the costs are related to drug acquisition.