A randomized, crossover evaluation of methylphenidate in cancer patients receiving strong narcotics.
Sedation may be a dose-limiting side-effect of opioid therapy in some cancer patients. This study was designed to evaluate further the use of the psychostimulant, methylphenidate, an agent that has been reported to counter-act opioid-induced sedation, in patients with cancer-related pain. Patients receiving a stable dose of an opioid for cancer-related pain were recruited for this randomized, double-blind, crossover clinical trial. In addition to their regular dose of narcotics, they received 5 days of methylphenidate followed by 5 days of placebo, or vice versa. Our data did not definitively demonstrate any statistically significant benefit for methylphenidate, but did suggest that this drug could mildly decrease narcotic-induced drowsiness and could increase night-time sleep. These data, in conjunction with other published data, suggest that methylphenidate can counteract narcotic-induced daytime sedation to a limited degree.
Wilwerding
M B
MB
Creighton University, University of Nebraska Medical Center and Associates, Omaha 68131, USA.
Loprinzi
C L
CL
Mailliard
J A
JA
O'Fallon
J R
JR
Miser
A W
AW
van Haelst
C
C
Barton
D L
DL
Foley
J F
JF
Athmann
L M
LM
D000293:Adolescent; D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009369:Neoplasms / Q000503:physiopathology; D010148:Intractable Pain / Q000188:drug therapy*; D010166:Palliative Care; D012894:Sleep Stages
D009294:Narcotics; D008774:Methylphenidate