8
Treatment
Cocaine Use Disorder: Modafinil
17. For patients with cocaine use disorder and without co-occurring
alcohol use disorder, clinicians can consider prescribing modafinil to
reduce cocaine use and improve treatment retention (L-C).
Cocaine Use Disorder: Topiramate and Extended-Release Mixed
Amphetamine Salts
18. For patients with cocaine use disorder, clinicians can consider
prescribing a combination of topiramate and extended-release mixed
amphetamine salts (MAS-ER) to reduce cocaine use and cocaine
craving (M-C).
a. Clinicians can give this combination additional consideration for patients
with co-occurring alcohol use disorder, as topiramate can also reduce alcohol
consumption (M-C).
b. Clinicians can give this combination additional consideration for patients with
co-occurring ADHD, as MAS-ER can also reduce ADHD symptoms (M-C).
Cocaine Use Disorder: Amphetamine Formulation
19. For patients with cocaine use disorder, clinicians can consider
prescribing a long-acting amphetamine formulation psychostimulant
to promote cocaine abstinence (L-C).
a. Clinicians can give long-acting amphetamine formulation psychostimulants
additional consideration for patients with co-occurring ADHD, as these
medications can also reduce ADHD symptoms (L-C).
b. When prescribing a long-acting amphetamine formulation psychostimulant,
clinicians can consider dosing at or above the maximum dose approved by the
United States Food and Drug Administration (FDA) for the treatment of
ADHD to effectively reduce cocaine use (L-C).
Amphetamine-Type Stimulant Use Disorder:
Methylphenidate (MPH) Formulations
20. For patients with ATS use disorder, clinicians can consider prescribing
a long-acting MPH formulation to promote reduced use of ATS (L-C).
a. Clinicians can give long-acting MPH formulations additional consideration for
patients with moderate or higher frequency of ATS use at treatment start (ie, 10
or more days per month; L-C).
b. Clinicians can give long-acting MPH formulations additional consideration
for patients with co-occurring ADHD, as these medications can also reduce
ADHD symptoms (L-C).
c. When prescribing a long-acting MPH formulation, clinicians can consider
dosing at or above the maximum dose approved by the FDA for the treatment
of ADHD to effectively reduce ATS use (L-C).
