Ritalin and Fatigue in Cancer Patients

People battling cancer often experience fatigue and low energy levels, despite getting adequate rest. Fatigue is one of the largest negative impacts on a cancer patient’s quality of life. In fact, in some surveys, patients identify fatigue as a more bothersome effect of cancer than pain. Treating the secondary effects of advanced disease, including fatigue, is one of the main goals of modern cancer research. Lifestyle interventions, such as physical exercise or group therapy, have yet to demonstrate significant improvement in terms of patient fatigue levels. Pharmaceutical approaches may be most effective in reducing cancer-related fatigue.

Ritalin (methylphenidate) is generally prescribed for attention deficit disorder in children and narcolepsy in children and adults, and it’s available in both immediate and sustained release formulations. There is conflicting evidence as to whether Ritalin might be useful in reducing cancer-related fatigue. While some studies have shown significant improvement in cancer patients’ quality of life after taking this medication, others have produced negative or insignificant results.

With cancer, researchers sometimes have difficulty separating the effects of an experimental treatment from a patient’s routine treatment. The most recent study of Ritalin and cancer fatigue, conducted in part by the Mayo Clinic, showed no significant improvement for all but the most serious cases of tiredness. Participants were placed into drug or placebo groups and administered identical tablets for three weeks. Fatigue and quality of life surveys were conducted at regular intervals. As with all drug research, however, primary effect is not the only consideration; adverse effects must be considered and carefully weighed against the desired outcome.

In the Mayo Clinic study, participants receiving daily sustained-release Ritalin reported nervousness and loss of appetite at a rate far greater than the placebo group. Patients with Stage III or IV cancer and severe fatigue showed the most significant improvement, but they also experienced the most adverse events. Whether or not the potential benefits outweigh risks must be decided on a case-by-case basis. Researchers acknowledged that perhaps immediate release Ritalin could offer greater benefit, and future investigations may take up this line of reasoning. As for now, a non-pharmaceutical approach to managing cancer-related fatigue may still be the safest alternative in most instances.

Fatigue, sleepiness, and even depression often linger for months or years after cancer has gone into remission. In many cases, the effects of cancer treatments are so damaging to healthy cells that full recovery is an uphill struggle. Currently, there is no overwhelmingly effective approach to reducing fatigue in cancer patients and survivors. Ritalin might be useful in advanced stages of the disease, but more study is needed to be certain.


  1. Methylphenidate – PubMed Health. (n.d.). National Center for Biotechnology Information. Retrieved April 16, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000606/
  2. Moraska, A.R., Sood, A., Dakhil, S.R., Sloan, J.A., Barton, D., Atherton, P.J., Suh, J.J. et al. (2010). Phase III, Randomized, Double-Blind, Placebo-Controlled Study of Long-Acting Methylphenidate for Cancer-Related Fatigue: North Central Cancer Treatment Group NCCTG-N05C7 Trial. Journal of Clinical Oncology, 28, (23), 3673-3679.

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  • Leave a Comment
  • Tony d

    January 25th, 2016 at 10:46 PM

    You have to experience this nitemare of CRF to understand it.
    I don’t worry about the cancer but the lack of energy,lack of interest in doing things with my wife.(cant go to the store,a movie,do some meaningful work at home.
    Sometimes is even hard to get up and pick a spoon.
    Ritalin works,I take enough of them.(generic)
    You can sleep all nite and wake up still fatigue.
    I can’t plan events with my wife without medications,very sad situation.
    You take whatever dose works as long as long as you have no side effects.
    I’m a prisoner in my home without the meds.
    People think your are the scum of the earth when you get your Rx filled.
    The the DEA IS looking to bust your doctor partly because of ignorance which is not their fault.
    I’m glad to be alive.
    I have no saliva,neck is fused,lost my hearing(l ear),teeth are gone,lost 64 lbs(gained about 35 back.had a peg tube,still have my port,and had 6 pet scans in last 4 years.
    In my opinion give us patients a break. Td/Tb
    So remember we are hurting with CANCER RELATED FATIGUE.
    I practice Internal Medicine for 27 years before I got sick.

  • Rose B.

    October 6th, 2017 at 8:04 AM

    My fatigue was horrible after the chemo, radiation, etc. I have small cell lung cancer but no pain. Sometimes I don’t feel like I have it except for the fatigue but I think that’s more from the chemo. If I have limited time here on earth, I want my quality of life as good as I can get it. Ritalin worked for me. One (10 mg) tab in the morning and one (10 mg tab) around 2:00 in the afternoon. There should be exceptions to the rules for Oncologists and Pharmacists when it comes to prescribing Ritalin to cancer patients.

    as far as having cancer and using it for fatigue.

  • Tonyd

    July 7th, 2016 at 9:00 AM

    I have found a great pharmacist,who gives me my Rx without issues.I have improved my quality of life with the MEDS.
    Thank god I found him.
    He’s a good man,caring,attentive,smart,hard working,pleasant,empathetic.
    I’m living more again with higher doses without side effects.I get closer to Rx day I get anxious if he is not there.
    God will bless him for helping people like me.Cancer is a pain in the buttocks

  • Amen4Docs

    October 24th, 2016 at 1:09 PM

    I was dx stage IV lung cancer over 2 years ago and have had continuous treatment since including lung radiation, targeted brain radiation, 25 rounds of chemo and 10 rounds of immunotherapy…all while still working full time on an adjusted schedule (work part in office/part from home). The pain was managed but the fatigue had become debilitating. I was literally nodding off at my desk even after 10 hours of sleep the night before. I just started Ritalin and it is amazing. Yes, I’m tired but I’m not sleep walking all day. It is a huge difference. I need to work for the health insurance – plus it helps keep my life somewhat “normal”. So glad I finally found a doc to prescribe it (palliative care doc prescribed it -onc and pcp would not). I just started taking it so I’m not sure if it will be effective long term – but for now it’s made a very positive impact in my quality of life.

  • Dick

    July 12th, 2017 at 3:53 PM

    Stage 4 lung cancer. 12 months of chemo, 11 opdivo infusions, fatigue and apithy. I take a 5mg
    Ritalin it the mornings and fell great all day and sleep al night.

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