Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia.
Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
Curr Drug Targets. 2018;19(8):877-887. doi: 10.2174/1389450118666170317162603.
One of the goals of cancer treatment is symptoms management especially at the end stage. The common symptoms in cancer include pain, fatigue, depression and cognitive dysfunction. The available treatment options for symptom management are limited. Methylphenidate, a psychostimulant, may be of benefit for these patients. In this report, we review the use of methylphenidate for symptoms control in cancer patients.
Electronic literature search on PubMed was conducted using the following keywords: methylphenidate, cancer, carcinoma, oncology, oncological and tumour. We identified forty two relevant studies and publications on the use of methylphenidate in cancer patients to be included in this review.
Methylphenidate was found to have some evidence in reducing opioid-induced sedation, improving cognitive symptoms and reduction of fatigue in cancer patients. Nevertheless, the results were inconsistent due to variations in the study populations, study design and outcome measures, among others. There was minimal evidence on its use in treating depression. Otherwise, methylphenidate was generally well-tolerated by patients.
This review potentially supports the use of methylphenidate for opioid-induced sedation, cognitive decline and fatigue in cancer patients. Further placebo-controlled trials would help in strengthening the evidence for this treatment.
癌症治疗的目标之一是症状管理,尤其是在晚期。癌症的常见症状包括疼痛、疲劳、抑郁和认知功能障碍。目前用于症状管理的治疗选择有限。哌醋甲酯,一种精神兴奋剂,可能对这些患者有益。在本报告中,我们回顾了哌醋甲酯在癌症患者症状控制中的应用。
使用以下关键词在 PubMed 上进行电子文献检索:哌醋甲酯、癌症、癌、肿瘤学、肿瘤学和肿瘤。我们确定了 42 项关于哌醋甲酯在癌症患者中应用的相关研究和出版物,纳入本综述。
哌醋甲酯在减少阿片类药物引起的镇静、改善认知症状和减轻癌症患者的疲劳方面有一定的证据。然而,由于研究人群、研究设计和结果测量等因素的差异,结果不一致。在治疗抑郁症方面的证据很少。除此之外,哌醋甲酯通常被患者耐受良好。
本综述可能支持哌醋甲酯用于治疗癌症患者的阿片类药物引起的镇静、认知功能下降和疲劳。进一步的安慰剂对照试验将有助于加强这种治疗的证据。