Treatment of Fatigue: Modafinil, Methylphenidate, and Goals of Care.

The article presents a case report of a 40 year old female malignant melanoma patient suffering from severe fatigue. Modafinil with a daily dose of 100 mg relieved tiredness in the patient but had to be discontinued following signs of side effects such as nervousness and restlessness. A dose of 20 mg/d of methylphenidate was effective and well tolerated over a period of 4 weeks. The case report suggests that the process of treatment goal identification, prioritization and adaptation is needed.