Perinatal EvidenceCompass
Prepopulated workbenchMED-241

Substance-use disorder — stimulant

Prescription psychostimulant substitution approaches

Investigational/off-label strategy for stimulant use disorder

Not a categorical safety rating

This record organizes questions; it does not close them.

The clinical fields and position statements are prepopulated from the public-source corpus. They have not completed individual dual extraction, formal appraisal, exact-label reconciliation, or multidisciplinary sign-off. Do not use this page to justify abrupt discontinuation or reflexive switching.

Inventory identity

What this record represents

Canonical generic name
Prescription psychostimulant substitution approaches
Entity type
therapeutic strategy/class
Active component(s)
Product- and protocol-specific stimulant
Formulation / route / interval
Regimen-specific
Attachment entry
Psychostimulant-substitution approaches
Separate monograph status
No — evidence appendix by studied molecule/regimen
Identity and cross-reference
Not populated in v0.95
Inventory verification confidence
High — direct status-changing or product-specific primary source

Decision taxonomy

Five positions kept separate

These are workbench statements for reviewer execution. They are not independently commissioned, patient-specific recommendations.

  1. 01

    Stable continuation

    Workbench statement

    Do not withhold or discontinue solely because of pregnancy or lactation. For this record, assess indication, prior response, relapse severity, dose/formulation, alternatives, exposure timing, and mapped evidence; individual commissioned adjudication remains pending.

  2. 02

    New initiation in pregnancy

    Workbench statement

    For a new start, prefer an effective option with the strongest diagnosis-specific efficacy and reproductive evidence when clinically suitable. This record has not received an individual, independently verified initiation ranking.

  3. 03

    Switch before conception

    Workbench statement

    Before conception, consider a switch only when expected benefit exceeds relapse, withdrawal, failed-switch, and dual-exposure risks. Build and monitor the plan before pregnancy when feasible; no universal switch direction is assigned here.

  4. 04

    Unplanned exposure

    Workbench statement

    After unplanned exposure, confirm product, route, dose, timing, indication, co-exposures, and symptoms; do not advise abrupt cessation. Use the mapped evidence and current label to decide whether any targeted fetal assessment is indicated.

  5. 05

    Delivery, postpartum & lactation

    Workbench statement

    Create separate delivery, postpartum-dose, neonatal-observation, and lactation plans. Do not infer breastfeeding suitability from pregnancy evidence or routinely taper before delivery without drug-specific support.

Linked evidence

2 mapped claim summaries

Mapping can include class-wide, framework, formulation, regulatory, or evidence-gap claims. A linked claim is not necessarily a drug-specific causal estimate.

C-024Provisional public source

No medication is FDA-approved for stimulant-use disorder; contingency management is the current standard behavioral intervention, while off-label medicines require specialist selection.

Public-source certainty descriptor
High guideline consensus; not GRADE-rated here
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Pregnancy and nonpregnant treatment
Comparator
Behavioral standard versus off-label pharmacotherapy
Effect or numbers carried forward

No approved pharmacologic effect estimate

Limitations

Access to contingency management varies; guideline medication evidence is mainly nonpregnant

Sources, citation controls, and verification state

Linked sources

PMID
Not populated in v0.95
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending
C-026Provisional public source

Prescription psychostimulant substitution studies are regimen-specific and mainly nonpregnant; a verified therapeutic prescription is not equivalent to nonmedical methamphetamine, cocaine, or counterfeit amphetamine exposure.

Public-source certainty descriptor
High conceptual certainty; low pregnancy treatment evidence
Formal appraisal
Not started — full text and independent appraisal pending
Exposure window
Preconception through lactation
Comparator
Monitored prescription versus nonmedical stimulant
Effect or numbers carried forward

No pregnancy StUD effectiveness estimate

Limitations

Molecule, dose, ADHD indication, cardiovascular risk and diversion vary

Sources, citation controls, and verification state

Linked sources

PMID
Not populated in v0.95
DOI
Pending DOI verification
Exact locator
Pending exact table/figure/page/supplement locator
Access date
2026-07-29
Integrity check
Same-day source surveillance recorded; source-by-source correction/retraction verification remains pending
Internal verification
Source-linked; independent external verification pending