Is methylphenidate a useful treatment for cancer-related fatigue in children?
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A 9-year-old boy with a brain tumour attends my outpatient clinic for review. His current most disabling symptom is fatigue. His parents have done a Google search and found that methylphenidate can be used to treat fatigue in adults. They ask my opinion as to whether this would be an option for their son. What should I advise?⇓
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Structured clinical question
In children with a brain tumour (subject), is methylphenidate (intervention) useful for treating fatigue (outcome)?
Search strategy and outcome
MEDLINE was searched from 1950 to February 2011 and EMBASE from 1980 to 31 March 2011 via the OVID interface. The advanced search mode was used. A keyword search was performed using ‘methylphenidate’ ‘cancer’ and ‘fatigue*’ as individual groups. The searches were then combined using the AND function. The results were subsequently restricted using the limits: ‘all children 0–18 yrs’ in MEDLINE and ‘child <unspecified>’ in EMBASE.
The Cochrane library was searched using the terms ‘methylphenidate’, ‘fatigue’, ‘cancer’ AND ‘child’. The search of EMBASE yielded no papers.
The search of MEDLINE revealed one paper which was read in full and shown to be for patients aged 18–70 years. The search of the Cochrane Library revealed no papers. Therefore, no relevant paediatric papers were found.
There were no papers found exploring the use of methylphenidate to treat fatigue in children with cancer. It was therefore decided to expand the search to include adult papers.
A second search …
Competing interests None.
Provenance and peer review Not commissioned; externally peer reviewed.