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Using Transcranial Magnetic Stimulation (TMS) to Treat Alcohol and Substance Abuse Disorders

Written by: Gary Warstadt MD

Alcohol and substance abuse disorders are complex conditions that pose significant challenges to individuals, families, and society as a whole. Traditional treatment approaches have been successful for many, but there remains a need for alternative interventions to complement existing therapies. Transcranial Magnetic Stimulation (TMS) shows real promise as a non-invasive and targeted treatment modality.

Several studies have investigated the effects of TMS on Alcohol Use Disorder (AUD). For example, Herremans et al. (2017) conducted a randomized controlled trial (RCT) involving individuals with AUD and found that high-frequency TMS over the dorsolateral prefrontal cortex (DLPFC) reduced alcohol consumption and craving compared to sham stimulation. Another RCT by Mishra et al. (2018) reported similar findings, with participants experiencing reduced craving and an increased duration of abstinence after receiving TMS over the DLPFC.

Preliminary evidence suggests that TMS may also be beneficial for individuals with Cocaine Use Disorder. For instance, Terraneo et al. (2016) conducted a pilot study and found that repetitive TMS over the dorsomedial prefrontal cortex (DMPFC) resulted in reduced cocaine craving and improved inhibitory control.

Limited research exists on TMS for Opioid Use Disorder (OUD), but early studies show promise. For instance, Rapinesi et al. (2016) conducted a case report on a patient with OUD who received TMS over the left DLPFC. The patient experienced reduced opioid cravings and improved mood, suggesting potential benefits of TMS in this population.

We must bear in mind that TMS is not yet FDA approved for treating alcohol or substance use disorders. Furthermore, the optimal treatment parameters, including stimulation intensity, frequency, and duration, are still being refined. We also know little about the maintenance of treatment gains over time.

Transcranial Magnetic Stimulation shows promise as a non-invasive and targeted approach to treating alcohol and substance abuse disorders. As TMS continues to evolve, it holds the potential to revolutionize the field of addiction treatment and improve the lives of individuals struggling with these challenging disorders.

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