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A randomized, crossover evaluation of methylphenidate in cancer patients receiving strong narcotics

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Abstract

Sedation may be a doselimiting side-effect of opioid therapy in some cancer patients. This study was designed to evaluate further the use of the psychostimulant, methylphenidate, an agent that has been reported to counteract opioid-induced sedation, in patients with cancer-related pain. Patients receiving a stable dose of an opioid for cancer-related pain were recruited for this randomized, double-blind, crossover clinical trial. In addition to their regular dose of narcotics, they received 5 days of methylphenidate followed by 5 days of placebo, or vice versa. Our data did not definitively demonstrate any statistically significant benefit for methylphenidate, but did suggest that this drug could mildly decrease narcotic-induced drowsiness and could increase night-time sleep. These data, in conjunction with other published data, suggest that methylphenidate can counteract narcotic-induced daytime sedation to a limited degree.

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Authors and Affiliations

  1. Nebraska Oncology Group, Creighton University, University of Nebraska Medical Center and Associates, 68131, Omaha, NE, USA

    Mary B. Wilwerding R.N., James A. Mailliard M.D. & John F. Foley M.D.

  2. Division of Medical Oncology, Mayo Clinic and Mayo Foudation, 200 First Street S.W., 55905, Rochester, MN, USA

    Charles L. Loprinzi M.D., Angela W. Miser M.B. & Carol van Haelst M.D.

  3. Cancer Center Statistics Unit, Mayo Clinic and Mayo Foudation, 200 First Street, S.W., 55905, Rochester, MN, USA

    Judith R. O'Fallon Ph.D.

  4. Clinical Oncology Program, Carle Cancer Center Community, 61801, Urbana, IL, USA

    Debra L. Barton R.N.

  5. Clinical Oncology Program, Duluth Community, 55805, Duluth, MN, USA

    Laurie M. Athmann R.N.

Authors
  1. Mary B. Wilwerding R.N.
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  2. Charles L. Loprinzi M.D.
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  3. James A. Mailliard M.D.
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  4. Judith R. O'Fallon Ph.D.
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  5. Angela W. Miser M.B.
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  6. Carol van Haelst M.D.
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  7. Debra L. Barton R.N.
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  8. John F. Foley M.D.
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  9. Laurie M. Athmann R.N.
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Additional information

Additional participating institutions include: Ochsner Community Clinical Oncology Program, New Orleans, LA 70121, USA (Carl G. Kardinal, M.D.) Rapid City Regional Oncology Group, Rapid City, SD 59709, USA (Larry P. Ebbert, M.D.) Siouxland Hematology-Oncology Associates, Sioux City, IA 51105, USA (John C. Michalak, M.D.) Toledo Community Clinical Oncology Program, Toledo, OH 43610, USA (Paul L. Schaefer, M.D.)

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Wilwerding, M.B., Loprinzi, C.L., Mailliard, J.A. et al. A randomized, crossover evaluation of methylphenidate in cancer patients receiving strong narcotics. Support Care Cancer 3, 135–138 (1995). https://doi.org/10.1007/BF00365854

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  • DOI: https://doi.org/10.1007/BF00365854

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