INTRODUCTION: Methylphenidate (MP) is often recommended for symptom control in advanced cancer. Little is known about its side effects in frail adults. OBJECTIVES: To evaluate MP-associated symptoms or side effects (S/E). METHODS: Data was collected from 2 published prospective cohort series and a phase 2 study of MP for symptom control in advanced cancer. All 3 reports had identical dosing schedules and symptom assessments. Initial MP doses were 10 mg/d (5 mg at 8 AM and at 12 noon) titrated up to a maximum of 30 mg/d. Depression, fatigue, and symptoms identified as possible MP S/E were evaluated for presence (prevalence) and for severity (using categorical scales) before MP (day 0) and on days 3, 5, and 7 thereafter. The categorical scale used was none, mild, moderate, and severe. RESULTS: 62 patients were enrolled. Fifty completed 7 days of MP with a median age of 69 (range 30-90) years. Thirty-five received MP 10 mg/day. Most (96%) had improvement in depression and/or fatigue. Among the 62 patients, new symptom prevalence throughout the study was agitation (16%), insomnia (16%), dry mouth (15%), nausea (10%), tremors (6%), anorexia (5%), headache (3%), palpitations (2%), and vomiting (2%). Patients could have more than 1 symptom simultaneously. Seven (11%) withdrew due to MP S/E. Some symptoms present before MP showed significant improvement during MP therapy. CONCLUSIONS: (1) Treatment with MP (10-20 mg/d) in advanced cancer is well tolerated. (2) S/E symptoms with MP appeared to improve spontaneously despite continued MP therapy. (3) Depression and fatigue improved at doses lower than those recommended in other clinical conditions. (4) MP improved depression and fatigue, and some secondary symptoms associated with them. Methylphenidate (MP) appears safe when used in the treatment of depression and fatigue in advanced cancer.
INTRODUCTION:Methylphenidate (MP) is often recommended for symptom control in advanced cancer. Little is known about its side effects in frail adults. OBJECTIVES: To evaluate MP-associated symptoms or side effects (S/E). METHODS: Data was collected from 2 published prospective cohort series and a phase 2 study of MP for symptom control in advanced cancer. All 3 reports had identical dosing schedules and symptom assessments. Initial MP doses were 10 mg/d (5 mg at 8 AM and at 12 noon) titrated up to a maximum of 30 mg/d. Depression, fatigue, and symptoms identified as possible MP S/E were evaluated for presence (prevalence) and for severity (using categorical scales) before MP (day 0) and on days 3, 5, and 7 thereafter. The categorical scale used was none, mild, moderate, and severe. RESULTS: 62 patients were enrolled. Fifty completed 7 days of MP with a median age of 69 (range 30-90) years. Thirty-five received MP 10 mg/day. Most (96%) had improvement in depression and/or fatigue. Among the 62 patients, new symptom prevalence throughout the study was agitation (16%), insomnia (16%), dry mouth (15%), nausea (10%), tremors (6%), anorexia (5%), headache (3%), palpitations (2%), and vomiting (2%). Patients could have more than 1 symptom simultaneously. Seven (11%) withdrew due to MP S/E. Some symptoms present before MP showed significant improvement during MP therapy. CONCLUSIONS: (1) Treatment with MP (10-20 mg/d) in advanced cancer is well tolerated. (2) S/E symptoms with MP appeared to improve spontaneously despite continued MP therapy. (3) Depression and fatigue improved at doses lower than those recommended in other clinical conditions. (4) MP improved depression and fatigue, and some secondary symptoms associated with them. Methylphenidate (MP) appears safe when used in the treatment of depression and fatigue in advanced cancer.
Authors: J Homsi; K A Nelson; N Sarhill; L Rybicki; S B LeGrand; M P Davis; D Walsh Journal: Am J Hosp Palliat Care Date: 2001 Nov-Dec Impact factor: 2.500
Authors: K Gehring; S Y Patwardhan; R Collins; M D Groves; C J Etzel; C A Meyers; J S Wefel Journal: J Neurooncol Date: 2011-10-02 Impact factor: 4.130
Authors: Gisele Pereira Dias; Ronan Hollywood; Mário Cesar do Nascimento Bevilaqua; Anna Claudia Domingos da Silveira da Luz; Robert Hindges; Antonio Egidio Nardi; Sandrine Thuret Journal: Neuro Oncol Date: 2014-01-26 Impact factor: 12.300
Authors: Andy Wolff; Revan Kumar Joshi; Jörgen Ekström; Doron Aframian; Anne Marie Lynge Pedersen; Gordon Proctor; Nagamani Narayana; Alessandro Villa; Ying Wai Sia; Ardita Aliko; Richard McGowan; Alexander Ross Kerr; Siri Beier Jensen; Arjan Vissink; Colin Dawes Journal: Drugs R D Date: 2017-03