• Reduction of 3 units between the two study groups of the subjective impression of asthenia measured at the first day before the beginning of the treatment with a visual analogical scale at day 7 (+/- 1 day) [ Time Frame: 7 days AVS ] [ Designated as safety issue: No ]
  

• Adverse events [ Time Frame: each day ] [ Designated as safety issue: Yes ]
  
• Visual analogical scale of pain [ Time Frame: inclusion, day 1, 2, 3, 7, 14 and 28 ] [ Designated as safety issue: No ]
  
• European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 [ Time Frame: day 1, 7 and 28 ] [ Designated as safety issue: No ]
  
• Multidimensional Fatigue Inventory-20 (MFI-20) [ Time Frame: day 1, 7, 14 and 28 ] [ Designated as safety issue: No ]
  
• Hospital Anxiety and Depression Scale (HADS) [ Time Frame: inclusion, 7 and 28 ] [ Designated as safety issue: No ]
  

Cancer patients in an advanced phase or who are terminally ill generally present with depression, pain, drowsiness, alterations of cognition, anorexia and other symptoms due to the progressive disease. The objective of the medical team of support and palliative care is to control these effects to maintain a quality of life. Particularly, the cancer patient in an advanced phase of the disease presents with important asthenia. In some patients, this asthenia is characterized by drowsiness or apathy. It always leads to ill-being and a sensation of bad adaptation. When an etiologic treatment is possible (correction of the anaemia, of the metabolic disorders, of the undernutrition, of the anorexia, of the insomnia, of the stubborn pain, of the psychological suffering), the asthenia can be fought. But, when it appears in patients not really in the end of life (life expectancy more than 1 month) and when no etiologic treatments are possible, other solutions must be considered, and all the more when the complaint is important with repeated requests for relief.

Methylphenidate is an amphetamine first indicated for deficient attention disorders with hyperactivity in children more than 6 years old. Several studies have been realized to evaluate its effect in cancer patients in palliative care. Some studies showed, in particular, its effectiveness on asthenia because of a stimulant and an antidepressant action. The methylphenidate could have an anti-analgesic effect or co-analgesic effect. All these studies are observational and not randomized. So they have a small level of proof and they have not been realized in a population of asthenic patients in palliative care. So a randomized controlled clinical trial in this specific population needs to be experimented.