title: Effect of methylphenidate in patients with cancer-related fatigue: a systematic review and meta-analysis.
abstract: BACKGROUND
  Cancer-related fatigue (CRF) is a common symptom affecting patients with cancer. There are an increasing number of trials examining potential treatments for CRF. Methylphenidate represents one of the most researched drugs and an up-to-date assessment of the evidence for its use is needed. Trials of methylphenidate for CRF provided inconsistent results. This meta-analysis was aimed at assessing the effect and safety of methylphenidate on CRF.
  
  
  METHODS
  We comprehensively searched the Pubmed, EMBASE, PSYCHInfo and the Cochrane databases in order to identify published studies on the effect of methylphenidate on CRF. Primary outcomes included fatigue. Secondary outcomes included depression, cognition and adverse effects.
  
  
  RESULTS
  A meta-analysis was conducted on five randomized controlled trials and 498 patients were enrolled. Despite a large placebo effect observed in the studies included, pooled data suggested therapeutic effect of methylphenidate on CRF. Subgroup Analyses showed that the efficacy of methylphenidate on CRF is getting better with prolonging treatment duration, with a MD of -3.70 (95% CI -7.03- -0.37, p = 0.03) for long-time group and a MD of -2.49 (95% CI -6.01-1.03, p = 0.17) for short-time group. In general, there was no impact of methylphenidate on depression and cognition associated with CRF. Adverse events were similar between methylphenidate and placebo groups except that more patients reported vertigo, anxiety, anorexia and nausea in methylphenidate group compared to placebo group.
  
  
  CONCLUSIONS
  Existing trials of methylphenidate on CRF provided limited evidence for the use of methylphenidate to treat CRF. The absolute numbers still remain small, and further confirmation is needed before firm recommendations on their usage and safety can be made in the treatment of CRF.
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Shun
authors.initials: S
authors.lastname: Gong
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China ; Neuroscience Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Sheng
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Jin
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: He
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Enbo
authors.initials: E
authors.lastname: Qi
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China ; Neuroscience Center, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Dong
authors.affiliation: Department of Neurosurgery, Shanghai Institute of Neurosurgery, PLA Institute of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
authors.forename: Lijun
authors.initials: L
authors.lastname: Hou
mesh_terms: D003071:Cognition / Q000187:drug effects; D003863:Depression / Q000150:complications / Q000188:drug therapy; D005221:Fatigue / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008774:Methylphenidate / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications*
chemical_list: D008774:Methylphenidate