rTMS – a useful tool in treating cocaine addiction?

Cocaine is a drug that is extensively abused and is extremely addictive. Worldwide about £62 billion of cocaine is sold each year; around a million people in the UK take cocaine with up to 20% of users becoming dependent. There is no approved pharmacotherapy to treat addiction, and behavioural/psychological approaches generally have limited success.

Repetitive transcranial magnetic stimulation (rTMS) is a form of neuromodulation: a safe and effective technique where a purpose‑made electromagnetic coil is placed against the patient’s scalp to deliver short, powerful magnetic pulses which induce electric currents in the cerebral cortex.  The treatment is painless and has minimal side effects so patients can go back to work, drive etc immediately afterwards.   rTMS is recommended to treat depression by United States’ Food and Drug Administration (FDA) and UK’s The National Institute for Health and Care Excellence (NICE).  Smart TMS use rTMS to treat depression, OCD and a range of other conditions, including cocaine and other addictions.

Evidence suggests that rTMS results in changes in brain activity, metabolism and connectivity.  rTMS stimulates parts of the brain which are involved in craving and has been shown in research and clinical settings to help reduce cocaine craving and consumption.
The rTMS treatment protocol for cocaine addiction requires 15 sessions of rTMS over three weeks.  Typically, the patient experiences an abrupt cessation of craving at about day seven, with the additional treatment serving to reinforce the effect and increase the durability.  As well as a reduction in craving, patients also experience a significant reduction in depression.  The effects can be made even more long lasting by monthly maintenance sessions after the first course of treatment.

In addressing the patient’s craving, rTMS can work alongside the behavioural and psychological approaches which AddCounsel already uses and so should be considered an important part of the treatment for cocaine addiction.  There is a growing evidence to suggest it also has application in a wide range of other addictions: metamphetamine, alcohol, gambling, porn, sex, etc..  Smart TMS, AddCounsel’s rTMS partner, has extensive experience of treating the full range of addictions.


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