Unidad de Medicina Paliativa y Control de Síntomas, Clínica Universidad de Navarra, Pamplona, Navarra, Spain.
Curr Opin Support Palliat Care. 2011 Jun;5(2):164-8. doi: 10.1097/SPC.0b013e3283462ff3.
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.
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.
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.
本文综述了最近研究检查的功效的精神兴奋剂的缓解症状如乏力和抑郁在癌症患者。
尽管迄今为止大多数研究都集中在使用哌醋甲酯为缓解症状如乏力和抑郁在癌症患者，越来越多的关注使用莫达非尼，一种精神兴奋剂的结构和机制与其他药物属于这一组不同。最初的研究主要调查了治疗抑郁症状在晚期癌症患者;然而，最近的研究评估了使用精神兴奋剂在癌症相关的疲劳确定亚组的患者和临床环境中，精神兴奋剂是最有效的。
为了缓解癌症患者化疗症状，哌醋甲酯和莫达非尼不比安慰剂更有效，尽管研究结果表明，这些精神兴奋剂可能在遭受更严重乏力或癌症晚期的患者中提供一些益处。哌醋甲酯显示出轻微的改善乏力和抑郁症状的研究中与安慰剂相比;来自唯一的 III 期研究表明，莫达非尼是一种有效的药物为晚期肿瘤患者。
