ADHD medication may help reduce fatigue in patients with blood and lymphatic cancers
A Danish study shows that methylphenidate led to a greater reduction in cancer-related fatigue than placebo. The treatment was investigated over six-week periods.
Cancer-related fatigue, also known simply as fatigue, is a persistent feeling of tiredness and exhaustion that is not relieved by rest or sleep. Fatigue is common among people with cancer and can significantly limit their ability to carry out everyday activities.
What is cancer-related fatigue?
Cancer-related fatigue is a persistent feeling of physical and mental tiredness or exhaustion that is not necessarily relieved by rest or sleep. It can cause significant limitations in everyday life and have a negative impact on quality of life.
Fatigue is very common among people with cancer. It affects at least half of all patients with cancer, and 40% experience limitations in their daily lives as a result of cancer-related fatigue.
Researchers in Denmark have now investigated the use of methylphenidate in patients with haematological cancers, for example cancers of the blood and lymphatic system. Methylphenidate is a stimulant medication used, among other things, to treat ADHD, and is the active ingredient in medicines including Ritalin. The drug has previously been investigated as a treatment for cancer-related fatigue in patients with cancers other than blood and lymphatic cancers, with mixed results.
- In our study, we measured a reduction in patients’ fatigue during the six weeks of treatment with methylphenidate, says Henrik Frederiksen, Professor of Haematology at the Department of Clinical Research, University of Southern Denmark and Odense University Hospital.
- During the first two weeks, we saw an improvement with both methylphenidate and placebo, but after that the improvement continued only with methylphenidate, says Henrik Frederiksen.
The patients regularly rated their fatigue using a questionnaire specifically designed for this purpose. The measurements showed a greater reduction in fatigue during treatment with methylphenidate than with placebo. On average, patients also had 0.7 more waking hours per day while receiving methylphenidate than while receiving placebo.
Three questions for Henrik Frederiksen about the study:
What are you investigating in this study? We are investigating whether the drug methylphenidate (MTP) - better known as Ritalin - can be used to alleviate the fatigue that is very common in patients with blood and lymphatic cancers. This is the first study of its kind in the world.
What is the most important finding? The study was a blinded crossover trial in which patients received either MTP or placebo tablets for six weeks in a random and blinded order. They then switched to the treatment they had not received during the first six weeks.
During the trial, the patients rated their fatigue and recorded their waking hours. The trial showed a noticeable improvement in fatigue and 0.7 more waking hours when they received MTP compared with the period in which they received placebo.
How can the results be used? There is currently no recognised medical treatment for cancer-related fatigue in patients with blood and lymphatic cancers. Our study shows that MTP may help some patients.
However, it is important to emphasise that exercise, psychological coping strategies and similar approaches may help reduce fatigue, and such measures should always be tried first.
According to the researchers, the new study is the first randomised trial specifically to investigate the treatment in patients with haematological cancers. The study included 152 patients.
Patients received both medication and placebo
The 152 participants were recruited from the eight haematology departments in Denmark. The trial was randomised and double-blind, meaning that neither the patients nor the researchers knew which treatment the patients were receiving at any given time.
In random order, patients received either methylphenidate or placebo for six weeks. After a one-week break without trial medication, they switched to the other treatment for a further six weeks. In this way, the patients effectively served as their own comparison group.
Of the 152 patients, 130 completed both treatment periods.
What is haematological cancer?
Haematological cancer is cancer of the blood, bone marrow or lymphatic system. It includes leukaemia, lymphoma and myeloma, among other diseases. These cancers develop when certain blood cells become abnormal and multiply uncontrollably.
Researchers do not yet know who benefits most
The study can only provide information about the effect of methylphenidate over treatment periods of six weeks. Nor does it show precisely which groups of patients benefit most from the treatment, and patients who had received chemotherapy within the preceding eight weeks were not eligible to participate.
Our results show that methylphenidate may be an option for alleviating fatigue in some patients with blood or lymphatic cancers, says Henrik Frederiksen.
He also emphasises that exercise and psychological interventions remain the most important approaches to cancer-related fatigue and should always be tried first.
Side effects were reported more frequently during treatment with methylphenidate than with placebo, but they were mostly mild. Among other things, patients reported increased dry mouth and nausea during treatment.
When we give a treatment intended to improve quality of life, it is particularly important that we also pay close attention to side effects. There is no point in replacing a consequence of the disease with a side effect that reduces quality of life, says Henrik Frederiksen.
The long-term effect is unknown
The study only investigated treatment over periods of six weeks. Further research is therefore needed to determine whether the effect persists in the longer term and which patients may benefit most from the treatment.
The study has been published in the Journal of Clinical Oncology. The results were previously presented at the annual meeting of the European Hematology Association in 2025.
About the study:
Method: The study included 152 adult patients with haematological cancer and persistent cancer-related fatigue. The patients were recruited from the eight haematology departments in Denmark.
In random order, patients received either methylphenidate or placebo for six weeks. After a one-week break, they switched to the other treatment for a further six weeks. Each patient therefore received both treatments and served as their own comparison. Neither the patients nor the researchers knew during the trial when an individual patient was receiving methylphenidate or placebo. Of the 152 patients, 130 completed both treatment periods.
Fatigue was measured before and during the trial using a questionnaire specifically designed to measure fatigue, in which a higher score indicates less fatigue. On average, patients’ scores increased by 8.9 points during treatment with methylphenidate and by 3.9 points during treatment with placebo. The difference between the treatments was therefore 5 points, exceeding the threshold that the researchers had specified in advance as a clinically relevant difference.
Funding and conflicts of interest: The study was supported by the Danish Cancer Society, the Danish Comprehensive Cancer Center, the Academy of Geriatric Cancer Research in Odense, the A.P. Moller Foundation and the Haematology Research Unit at Odense University Hospital. The publication states that the funders had no role in the study design, data collection and analysis, preparation of the manuscript or the decision to publish. The authors’ potential conflicts of interest are disclosed in the scientific article.
Read the study: The study “Methylphenidate for Hematological Cancer-Related Fatigue: A Randomized Clinical Trial” is published in the Journal of Clinical Oncology (JCO): DOI: 10.1200/JCO-26-00578
Meet the researcher
Henrik Frederiksen is Clinical Professor of Haematology at the Department of Clinical Research and chief consultant at the Department of Haematology, Odense University Hospital.