Abstract
Modafinil is a psychostimulant with a different mechanism of action to other similar drugs. It is approved for the treatment of excessive daytime sleepiness in relation with several causes. It has also been used in neurology illness- related fatigue with positive results. There is an increasing interest in modafinil as a potentially effective drug to improve fatigue. Following the trend to use other psychostimulants (e.g.,methylphenidate) to improve symptomatic problems in Palliative Care, we performed a review with the aim of exploring the use of modafinil to alleviate cancer - related fatigue. We analysed modafinil articles published in the last ten years, with particular attention to the practical aspects of its use (type of patient, dose, secondary effects, etc.), as well as prospective studies and randomised trials on cancer-related fatigue. The pharmacological profile of Modafinil is appropiate for advanced cancer patients. Four prospective studies and three randomised trials have examined its use since 2005. Between 46-90% of the 157 patients treated with 200 mg of modafinil had a significant improvement in fatigue. There were significant improvements in fatigue in two of the three randomised trials. Modafinil had a good tolerance in all of them. These results justify further research into the treatment of cancer-related fatigue, and meanwhile modafinil could be considered as an alternative for cancer - related fatigue.
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