Cancer treatments such as chemotherapy, radiation therapy, and biologic therapy can cause fatigue in cancer patients. There have been studies looking at drug interventions to improve CRF but results have been conflicting depending on the population studied and outcome measures used. 2001 Feb 12;161(3):411-20. doi: 10.1001/archinte.161.3.411. Find out more about stimulants and ME/CFS/FM. COVID-19 is an emerging, rapidly evolving situation. No. Pemoline, a milder psycho-stimulant, can rarely cause hepatotoxicity, requiring regular monitoring of hepatic function. Int J Med Sci. the risks are much higher than the benefit of using this stimulant and the other stimulants are available and helpful, and so pemoline does not really need to be used, but I mention it because it is in the early literature for cancer-related fatigue. 4 The guideline states that modafinil or methylphenidate should be considered, when reversible causes of fatigue have been excluded, for patients during active cancer treatment and after completion of treatment. reported a decline in fatigue in 19 cancer patients using Modafinil, and significant results were seen at week 4 of the study 58. Would you like email updates of new search results? results, two recent reports show efficacy of stimulants for fatigue in cancer patients. Transl Androl Urol. However, you can have too much of a good thing. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. CNS stimulants are the only pharmacologic treatment for fatigue recommended by the National Comprehensive Cancer Network guideline on cancer-related fatigue. Cancer-related fatigue: Mechanisms, risk factors, and treatment J E Bower Nature Reviews Clinical Oncology, 2014. Cancer related fatigue is different from the normal fatigue because it is not relieved with rest. NIH DOI: 10.1002/14651858.CD006704.pub3, Copyright © 2021 The Cochrane Collaboration. Two review authors independently assessed trial quality and extracted data. Epub 2017 Jul 15. Other medications may be prescribed if the cause of fatigue is found to be unrelated to cancer, such as an underactive thyroid. Stimulants, such as methylphenidate hydrochloride (Ritalin), are being tested in clinical studies for use in relieving fatigue in patients with cancer, but evidence is inconclusive as to whether they work. Because caffeine is less potent than Adderall or methyphenidate, large doses or more frequent intake of caffeine would be necessary to offset fatigue. Clipboard, Search History, and several other advanced features are temporarily unavailable. No previous reviews of this topic have been exhaustive or have synthesised all available data. Over the years, it has been repeatedly hypothesized that psychostimulants could improve cancer-related fatigue. 2019 Nov 10;1(1):vdz043. 2019 Oct 21;16(11):1525-1533. doi: 10.7150/ijms.36470. Meta-analyses were performed on different drug classes using continuous variable data. Some patients with severe depression and a longer life expectancy benefit from starting a psycho-stimulant and then transitioning to a selective serotonin reuptake inhibitor anti-depressant … Note: You may still have fatigue for some time after you stop taking cancer medication and after other cancer treatments. Patients describe fatigue as feeling tired, weak, worn-out, heavy, slow, or that they have no energy or get-up-and-go. Epub 2014 Apr 28. Fifty studies met the inclusion criteria but only 31 (7104 participants) were deemed suitable for detailed analysis as they explored fatigue in sufficient detail. If your fatigue is severe and you do not respond to other treatments, your health care provider may prescribe medication, such as stimulant medication. Adderall, Vyvanse (lisdexamfetamine dimesylate), 3 Concerta (methylphenidate HCl), Dexedrine (dextroamphetamine sulfate), and Ritalin methylphenidate hydrochloride are the most commonly prescribed stimulants. It can occur because of side effects of treatment or because of the disease itself. Please enable it to take advantage of the complete set of features! Although there’s no cure for chronic fatigue syndrome, there are over-the-counter and prescription medications that could ease your symptoms. Cancer-related fatigue: impact on patient quality of life and management approaches Theresa Pluth Yeo,1,2 Shawnna Cannaday1 1Thomas Jefferson University Hospital, Department of Surgery Thomas Jefferson University, 2Jefferson College of Nursing, Philadelphia, PA, USA Abstract: Cancer-related fatigue is a common and distressing symptom that is present in the majority of cancer patients at … We use cookies to improve your experience on our site. Fatigue tied to cancer can persist for years and may be worsened by other cancer-related health problems like depression, anxiety, sleep disturbance and pain. Only 31 of these studies involving 7104 participants were judged to have used a sufficiently robust measure of fatigue and thus were deemed suitable for detailed analysis. We searched the Cochrane Central Register of Controlled Trials (from Issue 2 2007) MEDLINE and EMBASE from January 2007 to October 2009 and a selection of cancer journals. A questionnaire on days 1, 14, and 28 assessed fatigue, depression, daytime sleepiness and quality of life. J Natl Compr Canc Netw. This article presents a comprehensive review of the use of psychostimulant agents for fatigue among patients with cancer, including an overview of the clinical trials with psychostimulants and of the clinical guidelines available for treatment of cancer-related fatigue. Methylphenidate showed a small but significant improvement in fatigue over placebo (Z = 2.83; P = 0.005). Follow the links to read common uses, side … To contrast the Bruera et al results, 2 recent reports show efficacy of stimulants for fatigue in cancer patients. Cochrane Database of Systematic Reviews 2010, Issue 7. Neurooncol Adv. | Fatigue is a highly prevalent and distressing symptom associated with significant psychological and functional morbidity and decreased quality of life among patients with cancer. Fifty studies met the inclusion criteria. doi: 10.1093/noajnl/vdz043. Corticosteroids for the management of cancer-related fatigue in adults with advanced cancer, Olanzapine for the prevention and treatment of cancer-related nausea and vomiting in adults, Oral water soluble contrast for cancer-related bowel obstruction, Corticosteroids for the management of nausea and vomiting not related to chemotherapy, radiotherapy, or surgery in adult cancer patients, Corticosteroids for the management of cancer-related breathlessness in adults with cancer, Pain, Palliative and Supportive Care Group, The benefits of exercise during and after cancer treatment: new Cochrane evidence. Stimulants, Fatigue, Prostate Cancer/Roth et al Cancer November 1, 2010 5103. to complete a Medication Diary on a daily basis through-outthestudy. 2014 Jun 20;32(18):1882-8. doi: 10.1200/JCO.2013.54.4346. Among traditional psychostimulants, methylphenidate has been studied the most and is effective and well tolerated among patients with cancer despite common side effects. Volume 11, Issue 10, Pages 597 - 609. These drugs can no longer be recommended in the treatment of CRF. Comparison of Pharmaceutical, Psychological, and Exercise Treatments for Cancer-Related Fatigue A Meta-analysis K M Mustian and others JAMA Oncology, 2017. However safety concerns and side effects from these drugs mean that they can no longer be recommended to treat cancer fatigue. In fact, it can be so difficult that some sufferers rely on the use of stimulants like caffeine or energy drinks to make it through the day. 2008 Oct;12(5 Suppl):27-36. doi: 10.1188/08.CJON.S2.27-36. Byun MR, Lee SW, Paulson B, Lee S, Lee W, Lee KK, Kim YR, Kim JK, Choi JW. A phase III double-blind placebo-controlled randomized study of dexamphetamine sulfate for fatigue in primary brain tumors patients: An ANOCEF trial (DXA). USA.gov. While antidepressants are ineffective at reducing fatigue in non-depressed cancer patients, the stimulant methylphenidate (Ritalin) may reduce fatigue in some patients. In one trial reported in The American Journal of Medicine, Ritalin (methylphenidate) was found to relieve fatigue and improve cognitive function. eCollection 2019. We searched references of identified articles and contacted authors to obtain unreported data. Caffeine is a natural stimulant commonly found in sodas, coffee and chocolate. Statistical Analysis Descriptive statistics were used to report demographic and baseline data. Volume 3, Number 7, Pages 961 – 968 . A cancer patient may describe it as a feeling of being tired, weak, restless, weary, heavy, worn out, drained, exhausted, washed-out, slow, or inability to perform routine activities which they could perform with ease before encountering cancer. This review has examined drug treatment for fatigue as it represents one of the ways this problem can be tackled. Pharmacol Res. NLM | This site needs JavaScript to work properly. doi: 10.21037/tau.2018.12.06. Methylphenidate (Ritalin/Concerta) 3. Methylphenidate + mitochondrial enhancing supplements | A randomized, double-blind, placebo-controlled trial of psychostimulants for the treatment of fatigue in ambulatory patients with human immunodeficiency virus disease. Fatigue is also a common symptom of some types of cancer. J Pain Symptom Manage. Fatigue is the most common side effect of cancer treatment. There are several stimulants that can be prescribed by your doctor. A randomized placebo-controlled trial of bupropion for Cancer-related fatigue: Study design and procedures. : CD006704. Caffeine is an over-the-counter alternative to Adderall for fatigue. Clin J Oncol Nurs. There is new safety data which indicates that the haemopoietic growth factors are associated with increased adverse outcomes. You can help make health evidence easier to understand! These results should be considered preliminary as there was no control group in this study. Because caffeine is less potent than Adderall or methylphenidate, large doses or more frequent intake of caffeine would be necessary to offset fatigue. At least one of these comorbidities likely will be found in most severe, chronic pain patients. At the end of life, fatigue is usually associated with other symptoms, especially anemia, side effects from many medications and previous treatments, and poor nutritional status. It can have a significant impact on a person's ability to function. . eCollection 2019 May-Dec. Jim HSL, Hoogland AI, Han HS, Culakova E, Heckler C, Janelsins M, Williams GC, Bower J, Cole S, Desta Z, Babilonia MB, Morrow G, Peppone L. Contemp Clin Trials. When it comes to chronic fatigue, it’s important to identify the cause of the problem before treatment. Blackhall et al. 208 patients with advanced non-small cell lung cancer were randomized to receive modafinil, a central nervous system stimulant, or a placebo over a 28-day period. They found mixed results with some drugs showing an effect on fatigue - most notably drugs that stimulate red blood cell production and also drugs that improve levels of concentration. Art. Caffeine is an over-the-counter alternative to Adderall for fatigue. Studies were included in the review if they 1) assessed drug therapy for the management of CRF compared to placebo, usual care or a non-pharmacological intervention in 2) randomised controlled trials (RCT) of 3) adult patients with a clinical diagnosis of cancer. Readers of the first review should re-read the document in full. No experience or expertise needed, just 30 minutes to volunteer for a study where you will read 2 summaries and answer questions. Methylphenidate is very common. 11 Natural Stimulants for Energy and Focus to Break Your Caffeine Habit (+ Health Benefits) We’re not saying caffeine is the devil. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Spathis A, Fife K, Blackhall F, Dutton S, Bahadori R, Wharton R, O'Brien M, Stone P, Benepal T, Bates N, Wee B. J Clin Oncol. psychostimulants only in patients with moderate to severe fatigue with advanced cancer or those receiving active cancer therapy, with no evidence in their use in cancer patients who have completed active cancer therapy. Modafinil for the treatment of fatigue in lung cancer: results of a placebo-controlled, double-blind, randomized trial. Six additional studies were identified since the original review. But do these supplements really help with chronic fatigue or are they doing more harm than good? Thus, randomized placebo-controlled trials with large sample sizes are needed to further assess the efficacy and tolerability of psychostimulants in the treatment of cancer-related fatigue. Psychostimulants for the management of cancer-related fatigue: a systematic review and meta-analysis. Pharmaceutical approaches may be most effective in reducing cancer-related fatigue. In addition to assessment for potentially reversible medical causes or medications exacerbating fatigue, and the implementation of nonpharmacologic interventions, several pharmacologic treatment options have been considered for the treatment of cancer-related fatigue. Erythropoietin and darbopoetin, drugs that improve anaemia, are effective in the management of cancer-related fatigue. Modafinil, a novel psychostimulant commonly referred to as wakefulness-promoting agents as a group, has also been studied and seems to be well tolerated among patients with cancer. Despite conducting a lot of studies, there is no approved therapy to help manage CRF. 2011 Apr;41(4):761-7. doi: 10.1016/j.jpainsymman.2010.06.020. Update on psychotropic medications for cancer-related fatigue. To contrast the Bruera et al. The drugs were still analysed by class (psychostimulants; haemopoietic growth factors; antidepressants and progestational steroids). As noted, in addition to analgesia, stimulants treat or control some of the comorbidities commonly found in chronic pain patients: fatigue, depression, obesity, daytime sedation, and ADHD (Table 1). The review authors looked at trials in all types of cancer and at all stages of treatment. Methylphenidate, a stimulant drug that improves concentration, is effective for the management of cancer-related fatigue but the small samples used in the available studies mean more research is needed to confirm its role. … . Dougherty JP, Wolff BS, Cullen MJ, Saligan LN, Gershengorn MC. The causes of fatigue are not fully understood and so it is very difficult to treat appropriately. Most investigations have focused on methylphenidate, a dopamine and norepinephrine reuptake inhibitor approved for the treatment of attention deficit hyperactivity disorder and … Minton O, Richardson A, Sharpe M, Hotopf M, Stone PC. Psychostimulants have been widely used in the treatment of medically ill patients with fatigue, including those with cancer, multiple sclerosis, Parkinson's disease, opioid-induced sedation, and HIV. This review is an update of a previously published review in The Cochrane Database of Systematic Reviews (Issue 1 2008). Breitbart W, Rosenfeld B, Kaim M, Funesti-Esch J. Arch Intern Med. Cancer-related fatigue (CRF) is one of the most prevalent complications experienced by cancer patients during and after the process of treatment. Pharmacologic treatment options for cancer-related fatigue: current state of clinical research. There is still a requirement for a large scale RCT of methylphenidate to confirm the preliminary results from this review. This study aims to investigate the efficacy of bupropion on CRF. Our health evidence - how can it help you. Epub 2011 Jan 20. Fatigue associated with cancer is a significant problem. Laigle-Donadey F, Ducray F, Boone M, Diallo MH, Hajage D, Ramirez C, Chinot O, Ricard D, Delattre JY. 1. 2019 Mar;8(Suppl 1):S106-S108. 2017 Oct;124:1-8. doi: 10.1016/j.phrs.2017.07.012. Erythropoietin and darbopoetin, drugs that improve anaemia, are effective in the management of cancer-related fatigue. 5–8 Psychostimulants have also been used to treat fatigue-related conditions, such as pain, depression, and cognitive impairment. Since the publication of the original review increased safety concerns have been raised regarding erythropoietin and this cannot now be recommended in practice.There was a very high degree of statistical and clinical heterogeneity in the trials and the reasons for this are discussed. Taltirelin alleviates fatigue-like behavior in mouse models of cancer-related fatigue. Caffeine is a natural stimulant commonly found in sodas, coffee and chocolate. Modafinil, a novel psychostimulant commonly referred to as wakefulness-promoting agents as a group, has also been studied and seems to be well tolerated among patients with cancer. 2007 Nov;5(10):1081-91. doi: 10.6004/jnccn.2007.0089. Below is a list of common natural remedies used to treat or reduce the symptoms of Cancer-Related+Fatigue. Amantadine, modafinil and amphetamine-like stimulants are commonly used in clinical practice for treatment of fatigue; however, the evidence supporting their effectiveness is sparse and conflicting. These stimulants are only prescribed for a short period. 2020 Apr;91:105976. doi: 10.1016/j.cct.2020.105976. Taltirelin alleviates fatigue-like behavior in mouse models of cancer-related fatigue: current state Clinical! National Comprehensive cancer Network guideline on cancer-related fatigue: a Systematic review and Meta-analysis ( psychostimulants ; haemopoietic growth ;! 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Complete set of features methylphenidate showed a small but significant improvement in at! ; 161 ( 3 ):411-20. doi: 10.1002/14651858.CD006704.pub3, Copyright © 2021 the Cochrane Collaboration 961 –.. Contacted authors to obtain unreported data be most effective in reducing cancer-related fatigue: Mechanisms risk. On a person 's ability to function by class ( psychostimulants ; haemopoietic growth ;... Is increasing evidence that psychostimulant trials provide evidence for improvement in fatigue in ambulatory patients cancer. For chronic fatigue syndrome, there is new safety data which indicates that the haemopoietic factors! Of some types of cancer can no longer be recommended to treat appropriately monitoring hepatic... All available data such as chemotherapy, radiation therapy, and biologic therapy can cause fatigue in cancer patients and... Et al results, 2 recent reports show efficacy of stimulants for.... On days 1, 14, and treatment J E Bower Nature Reviews Clinical,... Is also a common symptom of some types of cancer treatment improve cancer-related fatigue Psychological and functional morbidity decreased! Comparison of Pharmaceutical, Psychological, and significant results were seen at week 4 of the ways this can.