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Medline ® Abstract for Reference 83

of 'Pediatric palliative care'

83
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Patient-controlled methylphenidate for the management of fatigue in patients with advanced cancer: a preliminary report.
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Bruera E, Driver L, Barnes EA, Willey J, Shen L, Palmer JL, Escalante C
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J Clin Oncol. 2003;21(23):4439.
 
PURPOSE: To assess the effects of patient-controlled methylphenidate for cancer-related fatigue.
PATIENTS AND METHODS: In this prospective open study, 31 patients with advanced cancer and fatigue who scored>/= 4 on a scale of 0 to 10 received methylphenidate 5 mg by mouth every 2 hours as needed for 7 days (maximum, 20 mg/d). Multiple symptoms were assessed daily; the primary end point, fatigue, was measured using the 0 to 10 scale, and the Functional Assessment for Chronic Illness Therapy-Fatigue (FACIT-F) was performed at baseline, day 7, and day 28.
RESULTS: The following mean (+/- standard deviation) scores for 30 assessable patients improved significantly between baseline and day 7: fatigue (0 to 10 scale), 7.2 +/- 1.6 v 3.0 +/- 1.9 (P<.001); overall well-being (0 to 10 scale), 4.5 +/- 2.2 v 2.8 +/- 2.1 (P<.001); fatigue (FACIT-F) subscore, 17.5 +/- 11.3 v 34.7 +/- 10.0 (P<.001); functional well-being, 14.4 +/- 5.9 v 18.3 +/- 6.6 (P<.001); and physical well-being, 13.5+/- 6.4 v 21.4 +/- 5.0 (P<.001). Anxiety, appetite, pain, nausea, depression, and drowsiness all improved significantly (P<.05). All patients took afternoon or evening doses, and 28 patients (93%) took three or more doses daily. All patients chose to continue taking methylphenidate after 7 days of treatment. No serious side effects were reported.
CONCLUSION: These preliminary results suggest that patient-controlled methylphenidate administration rapidly improved fatigue and other symptoms. Randomized controlled trials are justified.
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Department of Palliative Care and Rehabilitation Medicine, The University of Texas M.D. Anderson Cancer Center, Unit 8, 1515 Holcombe Blvd, Houston, TX 77030, USA. ebruera@mdanderson.org
PMID