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Palliative Medicine
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Article

Modafinil for the treatment of fatigue in lung cancer: a pilot study

A Spathis1*, R Dhillan2, D Booden2, K Forbes3, K Vrotsou4, and K Fife1

1 Addenbrookes Hospital, Cambridge
2 Peterborough District Hospital, Peterborough
3 United Bristol Healthcare Trust, Bristol
4 Centre for Applied Medical Statistics, Cambridge

* To whom correspondence should be addressed.


  Abstract

Cancer-related fatigue is the most prevalent and distressing symptom experienced by patients with advanced cancer. Central nervous system stimulants have been shown to relieve fatigue in nonmalignant disease. Modafinil is a stimulant with a selective site of action in the brain that is better tolerated than traditional stimulants, such as methylphenidate. The aim of this study was to determine the feasibility of conducting a randomised controlled trial to assess the efficacy and safety of modafinil for the treatment of fatigue in patients with lung cancer. Twenty patients with non-small cell lung cancer were recruited to this open-label study. Modafinil was taken in a fixed dose-titration schedule of 100 mg daily for 7 days followed by 200 mg daily for 7 days. Fifteen patients completed the study. During the study period, there was a rapid and statistically significant reduction in the primary outcome, fatigue (P = 0.001) and the secondary outcomes of daytime sleepiness and depression/anxiety. This improvement in fatigue was also clinically significant. Ten patients chose to continue modafinil after the study and the drug was well-tolerated. It would be both feasible and worthwhile to conduct a definitive randomised controlled trial to determine the role of modafinil in the treatment of cancer-related fatigue.

Key Words: cancer, central nervous system stimulant, fatigue, lung cancer, modafinil

First published on March 6, 2009, doi:10.1177/0269216309102614

Palliative Medicine 2009;23:325.

A more recent version of this article appeared on June 1, 2009

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