Homsi, J., Nelson, K.A., Sarhill, N., Rybicki, L., LeGrand, S.B., Davis, M.P., & Walsh, D. (2001). A phase II study of methylphenidate for depression in advanced cancer. American Journal of Hospice and Palliative Care, 18, 403–407.

A phase II study of methylphenidate for depression in patients with advanced cancer

Patients who were identified as being depressed by a palliative medicine attending physician were treated with methylphenidate twice daily. Doses were titrated per regimen until response was obtained. Patients were assessed during a telephone call or bedside interview. The study timeframe was seven days.

• N = 30
• MALES: 50%, FEMALES: 50%
• KEY DISEASE CHARACTERISTICS: Primary cancer sites: breast (5), esophagus (4), head and neck (4), lung (4), pancreas (4), colorectal (2), and other (7)
• OTHER KEY SAMPLE CHARACTERISTICS: Inclusion criterion was the answer of “yes” to the question, “Are you depressed?” with no current or previous antidepressant use.

• SITE: One center was included.
• SETTING TYPE: Inpatients and outpatients were enrolled in the palliative care program.

• Question, “Are you depressed?”
• Other symptoms (anorexia, concentration problems, fatigue, and sedation) were assessed by a categorical rating (none, mild, moderate, or severe) before starting methylphenidate and daily thereafter.
• Pain was assessed using a 0–10 scale.
• Known side effects of methylphenidate also were assessed.
• Satisfaction question: ”Are you satisfied with the way the drug affected your mood?” was asked at the end of the study on day seven.

Depression was resolved in all patients, most on day three. The maximum daily dose needed was 20 mg. Other symptoms also improved, mean pain scores significantly decreased, and all who responded to treatment were satisfied with therapy.

• Small sample with no randomization
• Long-term efficacy and side effect data are needed.
• Single-site data are less transferable than multi-site data.