Dextroamphetamine or methylphenidate as adjuvants to opioid analgesia for adolescents with cancer.

Abstract

The doses of opioid analgesics required to control pain in patients with cancer may result in somnolence and reduced interaction with family members. Psychostimulants such as dextroamphetamine (DA, Dexedrine) or methylphenidate (MP, Ritalin) have been used in adults to counteract the sedation of opioid analgesia. We retrospectively reviewed our experience using these agents at Children's Hospital. Eleven patients (age 12-20 years) received DA or MP, and decreased somnolence or improved interaction was noted in five patients. Adverse effects potentially related to DA or MP were noted in two patients, none of which resulted in discontinuance of the stimulant. Further prospective, controlled studies are needed to assess the safety and efficacy of DA and MP in counteracting the sedation of opioid analgesia in children and adolescents.