Siu, S.W.K., Law, M., Liu, R.K.Y., Wong, K.H., Soong, I.S., Kwok, A.O.L., . . . Leung, T.W. (2014). Use of methylphenidate for the management of fatigue in Chinese patients with cancer. American Journal of Hospice & Palliative Medicine, 31, 281–286. 

To determine whether methylphenidate is useful for the management of fatigue in Chinese patients with cancer in the palliative care setting

Oral methylphenidate 5 mg daily; reassessed at day 8 and day 29 (if patient was still in study)

• N = 24  
• MEAN AGE = 64 years (SD = 47–81 years)
• MALES: 80%, FEMALES: 20%
• KEY DISEASE CHARACTERISTICS: Mostly gastrointestinal and lung cancers; patients receiving palliative or hospice care
• OTHER KEY SAMPLE CHARACTERISTICS: Fatigue score of at least 4 on 0–10 scale

• SETTING TYPE: Outpatient palliative care clinic or inpatient hospice
• LOCATION: Hong Kong, China

• PHASE OF CARE: Palliative
• APPLICATIONS: Palliative care

Prospective study

• Brief Fatigue Inventory (BFI)

For patients < 65 years old, scores were significantly lower at day 8 than at baseline but not at day 29. There were no significant differences at day 29 or in patients > 65 years old. Ten out of 24 patients stopped methylphenidate before day 8, with eight of the withdraws due to side effects of medication.

This study demonstrated no clinically significant effect for methylphenidate on cancer-related fatigue.

• Small sample (< 30)
• Risk of bias (no control group)
• Risk of bias (no blinding)
• Risk of bias (no random assignment)
• Subject withdrawals ≥ 10%
• Other limitations/explanation: There were a large number of refusals to participate in approached patients.

Methylphenidate is not recommended for the management of cancer-related fatigue.