Mitchell, G.K., Hardy, J.R., Nikles, C.J., Carmont, S.A., Senior, H.E., Schluter, P.J., . . . Currow, D.C. (2015). The effect of methylphenidate on fatigue in advanced cancer: An aggregated N-of-1 trial. Journal of Pain and Symptom Management, 50, 289–296.
To determine the efficacy of alleviating fatigue using the psychostimulant methylphenidate hydrochloride (MPH) in patients with advanced cancer
MPH 5 mg was taken orally twice daily versus placebo for three cycles of a pair of three-day periods. Patients completed a daily diary of symptom scales and side effects.
Population was estimated using the aggregated N of one multicycle, double-blinded, controlled, crossover study.
Eight patients had individual improvements in fatigue with MPH compared to a placebo on the FACIT-F and WCFS scores, but the mean population estimate showed no important difference. Seven patients showed an improvement in EDS scores, but the mean population estimate showed no important difference. There was no change in AKPS scores. There were six adverse events with three events possibly related to MPH.
Although there may be some individual improvement in fatigue with MPH use, the results of this small sample size were difficult to generalize.
Continued studies on the effects of psychostimulants on cancer-related fatigue are needed. This study adds to the growing body of evidence that methylphenidate is not generally helpful in reducing fatigue. The strength of this study's results are limited by design issues.