New Meta-Analysis in May 2026 Issue JNCCN – National Comprehensive Cancer Network Journal provide the latest evidence that methylphenidate-type psychostimulants, a class of drugs that increase the availability of dopamine and norepinephrine in the brain, can provide meaningful relief from cancer-related fatigue.
According to some estimates, cancer-related fatigue affects nearly three-quarters of people living with cancer, yet remains one of the most undertreated conditions in oncology.
According to the findings of this study, use of the prescription drugs methylphenidate (MPH) or dexmethylphenidate (d-MPH) was associated with significant improvements in fatigue scores compared to placebo across widely validated scales. These effects were shown to increase over time.
What makes this finding particularly noteworthy is the temporal aspect. The effects are not completely evident in the first few weeks, but by about 5 weeks they reach a truly significant level in terms of the patient’s daily energy and function. ”
Bruno Almeida Costa, MD, lead study author and fellow, The University of Texas MD Anderson Cancer Center
This is a meaningful contribution for people dealing with potentially seriously disabling conditions. We encourage cancer care professionals to consider methylphenidate not as a standalone solution, but as part of a broader approach to managing fatigue. The strongest evidence still belongs to exercise, cognitive behavioral therapy, and mind-body practices. However, it takes 8 to 12 weeks of consistent effort to reach its full potential. Methylphenidate may act as a bridge during that period, providing early relief until long-term strategies take effect. ”
Results were based on nine separate double-blind, individually randomized, parallel-group, placebo-controlled Phase II/III trials evaluating either MPH or d-MPH in adults with advanced cancer or actively receiving cancer-directed therapy. A total of 823 patients were included. The study was published from May 2006 to July 2024 and primarily assessed fatigue using the FACIT-F scale, a 13-item patient-reported questionnaire.
The authors note that MPH has “the longest and best-documented safety record of any actively prescribed controlled substance.” It has been on the market since 1955 and is approved for use in patients 6 years and older with ADHD and narcolepsy. This analysis found no statistically significant increase in side effects compared to placebo, although careful patient selection and regular monitoring remain important.
Dr. Costa added: “We are seeing an alarming trend in cancer diagnoses in young adults who are building careers, raising families, and leading very active lives. For this population, fatigue can have an especially severe impact because they have so much to do and want to do. “Our findings demonstrate that an established, readily available drug can provide meaningful symptom relief within a few weeks, providing clinicians with a practical tool to maintain daily function and support engagement with other treatments.”
Chandana Banerjee, MD, MPA, HMDC, FAAHPM, of City of Hope National Medical Center, who was not involved in this study and is vice chair of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Panel on Cancer-Related Fatigue, commented: “The emerging evidence on MPH/d-MPH highlights a broader principle in clinical care that through accurate and thoughtful patient selection and careful monitoring, modest effects can be turned into meaningful clinical benefits” and improve the patient experience. ”
sauce:
National Comprehensive Cancer Network
Reference magazines:
Berger, B.M.; others (2026) Methylphenidate-type psychostimulants for cancer-related fatigue: updated meta-analysis of randomized controlled trials. Journal of the National Comprehensive Cancer Network. DOI:10.6004/jnccn.2015.0122. https://jnccn.org/view/journals/jnccn/13/8/article-p1012.xml.
