title: The use of psychostimulants in cancer patients.
abstract: OBJECTIVE
  This article reviews the most recent studies that examine the efficacy of psychostimulants for the relief of symptoms such as asthenia and depression in cancer patients.
  
  
  RESULTS
  Although most research to date has focused on the use of methylphenidate for the relief of symptoms such as asthenia and depression in cancer patients, there is growing interest in the use of modafinil, a psychostimulant with a structure and mechanism that differs from other drugs belonging to this group. Initial studies mainly investigated the treatment of depressive symptoms in patients with advanced cancer; however, more recent studies have evaluated the use of psychostimulants in cancer-related fatigue identifying subgroups of patients and clinical settings in which psychostimulants are most efficient.
  
  
  CONCLUSIONS
  For the relief of chemotherapy symptoms in cancer patients, methylphenidate and modafinil were no more effective than placebo, although findings suggest that these psychostimulants may provide some benefit in patients who are suffering more severe asthenia or who are at advanced stages of the cancer. Methylphenidate showed marginal improvement in relation to symptoms such as asthenia and depression in studies in which it was compared with placebo; data from the only phase III study suggest that modafinil is an effective drug for advanced oncology patients.
authors.affiliation: Unidad de Medicina Paliativa y Control de Síntomas, Clínica Universidad de Navarra, Pamplona, Navarra, Spain. mportela@unav.es
authors.forename: María A
authors.initials: MA
authors.lastname: Portela
authors.forename: Alvaro S
authors.initials: AS
authors.lastname: Rubiales
authors.forename: Carlos
authors.initials: C
authors.lastname: Centeno
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001247:Asthenia / Q000188:drug therapy / Q000209:etiology; D001559:Benzhydryl Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003863:Depression / Q000188:drug therapy / Q000209:etiology; D005221:Fatigue / Q000188:drug therapy / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000077408:Modafinil; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D010166:Palliative Care / Q000379:methods; D017741:Survivors
chemical_list: D000970:Antineoplastic Agents; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000077408:Modafinil