Qu, D., Zhang, Z., Yu, X., Zhao, J., Qiu, F., & Huang, J. (2016). Psychotropic drugs for the management of cancer-related fatigue: A systematic review and meta-analysis. European Journal of Cancer Care, 25, 970–979.
DOI Link
Purpose
Search Strategy
Literature Evaluated
Sample Characteristics
- FINAL NUMBER STUDIES INCLUDED = 10
- TOTAL PATIENTS INCLUDED IN REVIEW = 1,582
- SAMPLE RANGE ACROSS STUDIES: 23–631 patients
Results
Four studies examined modafinil, and six evaluated used methylphenidate. The meta-analysis showed that methylphenidate reduced fatigue significantly (SMD = –0.28, p = 0.0005) and had no impact on sleep quality. Modafinil did not demonstrate a significant reduction in fatigue. Adverse effects were reported in 6.5% of patients getting methylphenidate, and no differences in study dropouts related to side effects existed between those on methylphenidate and those receiving placebo. The analysis showed no significant difference in risk of adverse events between those receiving either drug and those on placebo.
Conclusions
The findings showed that methylphenidate was associated with improvement in cancer-related fatigue, with no significantly increased risk of side effects. Modafinil was not associated with any improvement.
Limitations
- Relatively small number of studies
Nursing Implications
The findings suggest that methylphenidate is helpful to reduce cancer-related fatigue, with minimal adverse effects. Modafinil was not shown to be beneficial. Nurses need to be aware of the benefits and potential adverse effects when using psychotropic drugs to combat fatigue in patients with cancer.