Pharmacological treatments for fatigue associated with palliative care

Abstract

Based on limited evidence, we cannot recommend a specific drug for the treatment of fatigue in palliative care patients. Fatigue research in palliative care seems to focus on modafinil and methylphenidate, which may be beneficial for the treatment of fatigue associated with palliative care although further research about their efficacy is needed. Dexamethasone, methylprednisolone, acetylsalicylic acid, armodafinil, amantadine and L-carnitine should be further examined. Consensus is needed regarding fatigue outcome parameters for clinical trials.

Inflammation and the Silent Sequelae of Stroke

“…Fatigue is a particularly prevalent problem for patients with multiple sclerosis (MS) [117]. While a number of different drugs are used to treat MS-related fatigue, the data providing support for pharmacologic interventions are, at best, weak [118]. Exercise therapy may help treat fatigue in patients with MS, but the quality of most of these trials is limited [119].…”

Randomised controlled trial of a self-guided online fatigue intervention in multiple sclerosis

“…There was also inconclusive evidence for amantadine, modafinil and pemoline in a more recent meta-analysis 37. However, it should be noted that there are individual placebo-controlled trials of other drugs including aspirin38 and vitamin D,39 which might in the future also have a sufficient evidence base for clinical use, possibly in combination with efficacious behavioural interventions for MS fatigue.…”

Long-term Toxicity of Cancer Treatment in Older Patients

“…Pharmacologic interventions have been unsuccessful unless a specific diagnosis (ie. depression) can be made 91 .…”