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Methylphenidate side effects in advanced cancer: a retrospective analysis.
Wael Lasheen1, Declan Walsh, Fade Mahmoud
1Harry R. Horvitz Center for Palliative Medicine, Cleveland Clinic Taussig Cancer Center, Cleveland, OH 44195, USA.
The American Journal of Hospice & Palliative Care
|September 12, 2009
Summary
Methylphenidate (MP) is well tolerated for managing depression and fatigue in advanced cancer patients. Side effects were generally mild and often improved spontaneously during treatment.
Area of Science:
- Oncology
- Palliative Care
- Pharmacology
Background:
- Methylphenidate (MP) is frequently prescribed for symptom management in advanced cancer patients.
- Limited data exists on MP's side effects in elderly and frail individuals.
Purpose of the Study:
- To assess the symptoms and side effects associated with Methylphenidate (MP) in advanced cancer patients.
- Evaluate the safety and tolerability of MP for symptom control.
Main Methods:
- A pooled analysis of 2 prospective cohort studies and 1 phase 2 study involving MP for advanced cancer symptom control.
- Standardized dosing (10-30 mg/d) and symptom assessment (depression, fatigue, MP side effects) at baseline and on days 3, 5, and 7.
- Evaluation of symptom presence and severity using a categorical scale (none, mild, moderate, severe).
Main Results:
- 62 patients were enrolled; 50 completed 7 days of MP. The median age was 69 years.
- 96% of patients experienced improvement in depression and/or fatigue.
- Commonly reported new side effects included agitation (16%), insomnia (16%), and dry mouth (15%). 11% withdrew due to side effects.
Conclusions:
- Methylphenidate (MP) at 10-20 mg/d is well-tolerated in advanced cancer patients.
- MP effectively improved depression and fatigue, with some side effects showing spontaneous improvement.
- MP demonstrates safety for treating depression and fatigue in advanced cancer settings.
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