A Cochrane review included 26 studies with a total of 2366 subjects. Psychostimulants (bupropion, dextroamphetamine, methylphenidate, modafinil, mazindol, methamphetamine, and selegiline) did not reduce cocaine use (SMD 0.16, 95% CI -0.02 to 0.33), showed a trend favouring sustained cocaine abstinence (RR 1.41, 95% CI 0.98 to 2.02; 8 trials, n=811) and did not improve retention in treatment (RR 1.36, 95% CI 1.05 to 1.77). Psychostimulants did not improve retention in treatment (RR 1.00, 95% CI 0.93 to 1.06). The proportion of adverse event-induced dropouts and cardiovascular adverse event-induced dropouts was similar for psychostimulants and placebo (RD 0.00, 95% CI −0.01 to 0.01; RD 0.00, 95% CI −0.02 to 0.01, respectively). The proportion of patients achieving sustained cocaine abstinence was higher with bupropion and dexamphetamine than with placebo. Psychostimulants also appeared to increase the proportion of patients achieving sustained cocaine and heroin abstinence amongst methadone-maintained, dual heroin-cocaine addicts.