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Amphetamine-Type Stimulant Use Disorder: Bupropion and Naltrexone
12. For patients with ATS use disorder, clinicians can consider
prescribing bupropion in combination with naltrexone to promote
reduced use of ATS (M-C).
a. Clinicians can give this combination additional consideration for patients
with co-occurring alcohol use disorder, as naltrexone can also reduce alcohol
consumption (M-C).
b. Clinicians can give this combination additional consideration for patients with
co-occurring tobacco use disorder, as bupropion can also reduce nicotine/
tobacco use (M-C).
c. Clinicians can give this combination additional consideration for patients with
co-occurring depressive disorders, as bupropion can also treat depression (M-C).
Amphetamine-Type Stimulant Use Disorder: Topiramate
13. For patients with ATS use disorder, clinicians can consider
prescribing topiramate to reduce use of ATS (L-C).
a. Clinicians can give topiramate additional consideration for patients with
co-occurring alcohol use disorder, as this medication can also reduce alcohol
consumption (L-C).
Amphetamine-Type Stimulant Use Disorder: Mirtazapine
14. For patients with ATS use disorder, clinicians can consider
prescribing mirtazapine to promote reduced use of ATS (L-C).
a. Clinicians can give mirtazapine additional consideration for patients with co-
occurring depressive disorders, as this medication can also treat depression (L-C).
Psychostimulant Medication
General Psychostimulant Medication
15. Recommendations related to the prescription of psychostimulant
medications to treat StUD are only applicable to:
a. physician specialists who are board certified in addiction medicine or addiction
psychiatry; and
b. physicians with commensurate training, competencies, and capacity for close
patient monitoring (CC-S).
16. When prescribing psychostimulant medications for StUD, clinicians
should maintain a level of monitoring commensurate with the risk
profile for the given medication and patient. Monitoring may include
pill counts, drug testing, more frequent clinical contact, and more
frequent prescription drug monitoring program (PDMP) checks (CC-S).
