Repetitive Transcranial Magnetic Stimulation for Cocaine Use Disorder: An Observational Study

Area of Science:

• Neuroscience
• Psychiatry
• Addiction Medicine

Background:

• Cocaine use disorder (CUD) has high relapse rates and limited effective treatments.
• Repetitive transcranial magnetic stimulation (rTMS) is a potential therapeutic option, but clinical evidence is limited.
• This study investigates the real-world effectiveness of rTMS for CUD.

Purpose of the Study:

• To evaluate the clinical outcomes of rTMS in patients with CUD.
• To identify factors associated with treatment success and relapse.
• To assess the safety and feasibility of rTMS in a naturalistic setting.

Main Methods:

• A retrospective study of 93 CUD patients treated with rTMS between 2018-2021.
• rTMS involved 32 sessions of high-frequency (10 Hz) left dorsolateral prefrontal cortex stimulation.
• Data collected included sociodemographics, cocaine use, psychopathology, and treatment dropout.

Main Results:

• Baseline abstinence predicted lower relapse risk (OR 1.42-1.95) and higher treatment completion (70.3%).
• Abstinence probability was 58.6% for baseline abstinent patients vs. 33.6% for active users.
• Craving, anxiety, and depressive symptoms significantly decreased over time (P < .001); sleep quality also improved.

Conclusions:

• rTMS is associated with reduced craving and improved clinical outcomes in CUD patients.
• Baseline abstinence and younger age correlate with lower relapse rates and better treatment retention.
• rTMS appears to be a safe and promising adjunctive therapy for CUD.