Palliative uses of methylphenidate in patients with cancer: a review.
OBJECTIVE
Cancer is, unfortunately, often a terminal disease. The goal of therapy for many patients with cancer is palliation of symptoms common at the end of life, including pain, depression, and cognitive dysfunction. Methylphenidate is a psychostimulant most commonly used in the treatment of attention deficit hyperactivity disorder. In this report, we review the use of methylphenidate in the palliative care of patients with cancer.


METHODS
This review was written on the basis of a computerized literature search of Medline. We considered all English language publications from 1966 to present using the following key words: methylphenidate, palliative care, and cancer. Forty-nine articles were identified as being relevant for this review.


RESULTS
On the basis of this review, we came to the conclusion that methylphenidate is used to ameliorate opioid-induced somnolence, to augment the analgesic effects of opioids, to treat depression, and to improve cognitive function in patients with cancer.


CONCLUSIONS
The medical literature supports the palliative use of methylphenidate in the care of patients with cancer. Further placebo-controlled trials are needed to elucidate the precise role that methylphenidate will have in providing symptom relief to dying patients.
Rozans
Mark
M
Department of Medicine, Tulane University School of Medicine, 1430 Tulane Ave., New Orleans, LA 70131, USA.
Dreisbach
Albert
A
Lertora
Juan J L
JJ
Kahn
Marc J
MJ
D000701:Analgesics, Opioid / Q000009:adverse effects; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology; D003863:Depression / Q000188:drug therapy / Q000209:etiology; D006970:Disorders of Excessive Somnolence / Q000139:chemically induced / Q000188:drug therapy; D006801:Humans; D008774:Methylphenidate / Q000627:therapeutic use*; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D010166:Palliative Care / Q000379:methods*
D000701:Analgesics, Opioid; D000697:Central Nervous System Stimulants; D008774:Methylphenidate