Pharmacologic interventions remain the core of therapy. The same
medications are used to treat depression in terminally ill as in nonterminally
ill patients. Psychostimulants may be preferred for patients
with a poor prognosis or for those with fatigue or opioid-induced somnolence.
Psychostimulants are comparatively fast acting, working
within a few days. Dextroamphetamine or methylphenidate should be
started at 2.5 to 5.0 mg in the morning and at noon, the same starting
dosages used for treating fatigue. The dose can be escalated up to
15 mg twice a day; higher doses are only rarely necessaryPharmacologic interventions remain the core of therapy. The same
medications are used to treat depression in terminally ill as in nonterminally
ill patients. Psychostimulants may be preferred for patients
with a poor prognosis or for those with fatigue or opioid-induced somnolence.
Psychostimulants are comparatively fast acting, working
within a few days. Dextroamphetamine or methylphenidate should be
started at 2.5 to 5.0 mg in the morning and at noon, the same starting
dosages used for treating fatigue. The dose can be escalated up to
15 mg twice a day; higher doses are only rarely necessary