Effect of methylphenidate in patients with cancer-related fatigue: a systematic review and meta-analysis

PLoS One. 2014 Jan 8;9(1):e84391. doi: 10.1371/journal.pone.0084391. eCollection 2014.


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.

Findings: 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.

Conclusion: 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.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Cognition / drug effects
  • Depression / complications
  • Depression / drug therapy
  • Fatigue / complications*
  • Fatigue / drug therapy*
  • Fatigue / physiopathology
  • Humans
  • Methylphenidate / adverse effects
  • Methylphenidate / pharmacology*
  • Methylphenidate / therapeutic use
  • Neoplasms / complications*


  • Methylphenidate

Grants and funding

Dr. Yan Dong is supported by Natural Science Foundation from Science and Technology Commission of Shanghai Municipality (11ZR1448700) and Research Foundation for Returned Scholars from Ministry of Education of China. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.