Effect of transcranial alternating current stimulation (NET Device™) on psychostimulant withdrawal severity and time...

Psychostimulant use disorder is a life-threatening condition with no FDA-approved treatment. Stimulant withdrawal symptoms impede treatment engagement and are unaddressed by standard of care. The NET Device, a non-invasive transcranial alternating current stimulator, is FDA-cleared for opioid withdrawal suppression. No studies have evaluated whether NET Device use attenuates psychostimulant withdrawal.

Electronic health record and device utilization data were collected from 109 stimulant-only users and 112 stimulant/opioid co-users (N = 221 adults total; M _age=39.2, SD _age=10.7; 119M) entering residential addiction treatment (n = 168) or detention centers (n = 53). The Amphetamine Cessation Symptom Assessment (ACSA) was administered at baseline and 1 hour (day 1), and twice daily on days 1-7. A linear mixed model (LMM) with random intercepts and slopes was used to analyze the trajectory of ACSA scores.

ACSA severity and time course were similar across settings (residential vs. detention). A two-phase LMM separated acute (baseline to 1 hour) and post-acute withdrawal symptom reductions. Relative to baseline ACSA scores, stimulant-only and co-user groups each reported significant reductions at 1 hour (46% and 33%), day 2 morning (59% and 42%), and decelerating log-time trajectory through day 4 (79 hours), the primary analysis window. Estimates beyond day 4 rest on 6.9% of observations and are reported as exploratory only.

NET Device monotherapy was associated with rapid reduction in psychostimulant withdrawal severity regardless of setting and opioid co-use. No device-related adverse events were reported. These real-world data support initiation of a sham-controlled randomized trial to evaluate NET Device efficacy for stimulant use disorder.