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rTMS for Co-occurring Psychiatric and Substance Use Disorders: Narrative Review and Future Directions
Sophia H Blyth1, Nicole L Zabik2, Amanda Krosche1
1Department of Psychiatry and Behavioral Sciences, Vanderbilt Psychiatric Hospital, Vanderbilt University Medical Center, 1601 23rd Avenue South, Nashville, TN 37232, USA.
Current Addiction Reports
|July 30, 2025
Summary
Repetitive transcranial magnetic stimulation (rTMS) shows promise for treating co-occurring substance use disorders (SUDs) and psychiatric illnesses. Further research is needed to confirm efficacy and explore novel treatment targets for these complex conditions.
Area of Science:
- Neuroscience
- Psychiatry
- Addiction Medicine
Background:
- Co-occurring substance use disorders (SUDs) are prevalent in individuals with psychiatric illnesses, often leading to poorer mental health outcomes and reduced treatment effectiveness.
- Currently, no FDA-approved treatments specifically target the dual diagnosis of co-occurring psychiatric and SUDs.
- Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, is being investigated as a potential therapeutic option.
Purpose of the Study:
- To comprehensively review existing literature on the efficacy of rTMS for treating co-occurring SUDs in patients with psychiatric disorders.
- To identify potential neural circuitry targets and discuss future research directions for rTMS interventions in this population.
Main Methods:
- A systematic literature search was conducted across PubMed, MEDLINE, and Google Scholar databases.
- Studies were manually reviewed to identify all research investigating the effects of rTMS on co-occurring SUDs.
- Eleven studies met the inclusion criteria for the review.
Main Results:
- The majority of included studies (7/11) focused on rTMS for schizophrenia with co-occurring SUDs.
- Three studies examined rTMS for SUDs in patients with mood and anxiety disorders.
- Preliminary evidence suggests rTMS may be effective, with potential neural targets identified for various comorbid conditions.
Conclusions:
- Repetitive transcranial magnetic stimulation (rTMS) demonstrates preliminary efficacy in treating co-occurring psychiatric and substance use disorders.
- Additional research is crucial to validate findings, explore novel treatment targets, and optimize rTMS protocols for this complex patient group.
- Future research should consider pragmatic approaches, substance withdrawal, state dependence, neurobiological markers, and individual predictors of treatment response.
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