Trial Information

Randomized Study Evaluating the Antiasthenic Effect of Methylphenidate (Ritalin) in Palliative Care in Cancer Patients

Cancer patients in an advanced phase or who are terminally ill generally present with
depression, pain, drowsiness, alterations of cognition, anorexia and other symptoms due to
the progressive disease. The objective of the medical team of support and palliative care is
to control these effects to maintain a quality of life. Particularly, the cancer patient in
an advanced phase of the disease presents with important asthenia. In some patients, this
asthenia is characterized by drowsiness or apathy. It always leads to ill-being and a
sensation of bad adaptation. When an etiologic treatment is possible (correction of the
anaemia, of the metabolic disorders, of the undernutrition, of the anorexia, of the
insomnia, of the stubborn pain, of the psychological suffering), the asthenia can be fought.
But, when it appears in patients not really in the end of life (life expectancy more than 1
month) and when no etiologic treatments are possible, other solutions must be considered,
and all the more when the complaint is important with repeated requests for relief.

Methylphenidate is an amphetamine first indicated for deficient attention disorders with
hyperactivity in children more than 6 years old. Several studies have been realized to
evaluate its effect in cancer patients in palliative care. Some studies showed, in
particular, its effectiveness on asthenia because of a stimulant and an antidepressant
action. The methylphenidate could have an anti-analgesic effect or co-analgesic effect. All
these studies are observational and not randomized. So they have a small level of proof and
they have not been realized in a population of asthenic patients in palliative care. So a
randomized controlled clinical trial in this specific population needs to be experimented.