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Methylphenidate for fatigue in advanced cancer: A prospective open-label pilot study

Harry R. Horvitz Center for Palliative Medicine, a World Health Organization Demonstration Project in Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio

Declan Walsh, FACP, FRCP (Edin)

Harry R. Horvitz Center for Palliative Medicine, a World Health Organization Demonstration Project in Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Harry R. Horvitz Chair in Palliative Medicine, Cleveland Clinic Foundation, Cleveland, Ohio

Kristine A. Nelson, MD

Harry R. Horvitz Center for Palliative Medicine, a World Health Organization Demonstration Project in Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Palliative Medicine, Cleveland Clinic Foundation, Cleveland, Ohio

Jade Homsi, MD

Harry R. Horvitz Center for Palliative Medicine, a World Health Organization Demonstration Project in Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio

Susan LeGrand, MD

Harry R. Horvitz Center for Palliative Medicine, a World Health Organization Demonstration Project in Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio

Mellar P. Davis, MD

Harry R. Horvitz Center for Palliative Medicine, a World Health Organization Demonstration Project in Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland Clinic Foundation, Cleveland, Ohio

Psychostimulants such as methylphenidate are used for fatigue in cancer patients. We report a prospective, open-label, pilot study of the successful use of methylphenidate to treat fatigue in nine of 11 consecutive patients with advanced cancer. Seven had received radiation or chemotherapy, a median of three weeks (range from one to 30 weeks) prior to methylphenidate. A rapid onset of benefit was noted, even in the presence of mild anemia. Sedation and pain also improved in some. Only one patient had side effects severe enough to stop the medication.

Key Words: cancer • fatigue • methylphenidate • psychostimulant • symptom management

American Journal of Hospice and Palliative Medicine®, Vol. 18, No. 3, 187-192 (2001)
DOI: 10.1177/104990910101800310


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