TMS for Addiction

Repetitive Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive, non-drug, with zero downtime that has been proven as a safe and effective treatment for depression and OCD. However, recently, TMS therapy has been prescribed for a number of other conditions as a safe and “off-label” alternative, and more and more use cases for TMS are being studied every day. One of those cases is the use of TMS therapy for substance abuse treatment and substance addiction.

TMS has been increasingly gaining recognition as a potential, non-invasive treatment for addiction due to its promising effects on the areas of the brain responsible for mood and desire. Transcranial magnetic stimulation has generated enthusiasm for its potential to address the complex nature of addiction and drug abuse, providing optimism to those who have tried other forms of treatment with limited success.

What is TMS?

Transcranial Magnetic Stimulation (TMS) therapy is a non-invasive procedure that uses magnetic fields to stimulate specific regions of the brain, targeting neural pathways involved in addiction. During a TMS session, an electromagnetic coil is placed on the scalp, delivering magnetic pulses to targeted areas of the brain associated with mental health conditions like depression, anxiety, and certain neurological disorders. TMS therapy is typically conducted over several sessions and has been shown to be effective for individuals who have not responded well to other forms of treatment.

TMS has been proven effective in treating depression and obsessive-compulsive disorder and is believed to be effective in treating several other mental health conditions, including addiction.

Understanding Addiction

Addiction is a complex and chronic brain disease that affects millions of people worldwide. It occurs when an individual becomes physically or psychologically dependent on a substance, such as drugs or alcohol, or engages in compulsive behaviors like gambling. The neurobiological mechanisms¹ involved in addiction include changes to the brain’s reward system, leading to cravings and compulsive use.

The Science Behind Addiction

When consumed, certain substances release large quantities of dopamine, a neurotransmitter responsible for pleasure and motivation, is released in large quantities by substances or activities which can hijack the brain’s natural reward system leading to cravings and compulsive use over time. Depending on the drug, this excessive stimulation can lead to long-lasting changes in the brain’s structure and function in a very short amount of time, making it difficult for individuals to quit using these substances despite negative consequences.

Current Treatment Approaches and Limitations

Treating addiction often involves various approaches such as medication-assisted treatment (MAT), behavioral therapies like cognitive-behavioral therapy (CBT) and motivational interviewing (MI), support groups like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA), residential rehabilitation programs, and even sober living communities. While many individuals find success with these treatments, some continue struggling with their addictions due to factors like genetic predisposition, environmental influences, or co-occurring mental health disorders.

Research on TMS for Addiction

As our understanding of addiction as a chronic brain disease grows, researchers are exploring innovative treatment approaches like Transcranial Magnetic Stimulation (TMS). TMS uses magnetic fields to stimulate specific areas of the brain associated with substance use disorders. By targeting specific brain regions associated with addictive behaviors, TMS can help regulate neural activity, leading to a decrease in the urge to consume drugs or alcohol. Let’s dive into some key clinical studies investigating the efficacy of TMS in addiction and their findings.

Evidence Supporting TMS for Substance Use Disorders

A growing body of research suggests that TMS may be an effective treatment option for various types of addictions. For instance, a meta-analysis conducted in 2014² found that high-frequency repetitive TMS (rTMS) significantly reduced cravings in individuals with alcohol and nicotine dependence. Another study published in JAMA Psychiatry reported that rTMS led to a significant reduction in cigarette consumption among smokers who did not respond well to conventional treatments.

Findings from Studies on Specific Substances

Nicotine: A randomized controlled trial demonstrated that rTMS applied over the dorsolateral prefrontal cortex (DLPFC) resulted in decreased cigarette consumption and increased abstinence rates among participants. Furthermore, these effects were maintained at follow-up assessments up to six months later.
Alcohol: Researchers found³ that applying high-frequency rTMS over the DLPFC significantly reduced alcohol craving scores compared to sham stimulation. This suggests that TMS may be a promising treatment for alcohol use disorder.
Cocaine: Another study⁴ showed that rTMS targeting the DLPFC significantly reduced cocaine craving and consumption among individuals with cocaine use disorder. The results highlight the potential of TMS as an adjunctive therapy to standard addiction treatments.

Using TMS therapy to treat addiction has shown promising results across various substances, including nicotine, alcohol, and cocaine. TMS, with its capacity to target certain brain regions related to addictive behavior, may provide a valuable option for supplementing or replacing standard treatments for substance use disorders.

TMS Addressing Comorbid Conditions in Addiction Treatment

TMS, while potentially effective by itself for addiction, may be even more successful when combined with other treatments. Combining TMS with other evidence-based interventions may enhance their effectiveness respectively.

At Neuro Wellness Spa we believe that addiction goes hand in hand with mental health. Almost every time, a patient struggling with a substance use disorder is actually using drugs as a coping mechanism for an underlying mental health condition. When a person is diagnosed with a simultaneous substance abuse problem and a mental health disorder, it’s called a dual diagnosis.

Without addressing the mental health element of addiction, an individual is not likely to see lasting sobriety. Psychological conditions such as depression and anxiety can complicate the recovery process by exacerbating symptoms or hindering treatment adherence. Fortunately, TMS has proven effective not only for addiction but also for these accompanying disorders. After all, TMS therapy was initially approved by the FDA for the treatment of major depressive disorder and treatment-resistant depression. Addressing both addiction and its underlying causes simultaneously through targeted brain stimulation sessions tailored specifically for each patient’s needs means treatment providers at Neuro Wellness Spa can offer a comprehensive approach to recovery. By incorporating multiple therapeutic modalities into a personalized treatment plan, our care team can help patients achieve lasting recovery from addiction and improve their mental health simultaneously.

Challenges and Future Directions

The potential of transcranial magnetic stimulation (TMS) as a treatment for addiction is promising, but there are several challenges and areas that require further exploration.

Limitations of Current Research

Studies into TMS for treating addiction symptoms such as cravings and substance consumption have yielded promising results, yet further exploration is required to determine its enduring effectiveness. Many existing studies have small sample sizes or lack control groups, making it difficult to draw definitive conclusions about the effectiveness of TMS in treating various forms of addiction. Furthermore, most research has focused on specific substances like nicotine or cocaine; additional investigations should explore how effective TMS can be when applied to other types of addictions, including behavioral addictions such as gambling addiction or sex addiction.

Factors Influencing Effectiveness

Different factors may influence the success rate of using repetitive transcranial magnetic stimulation (rTMS) for treating addiction. These include individual differences among patients (e.g., genetics), duration and severity of drug abuse history, comorbid psychiatric conditions (e.g., depression), and choice between high-frequency vs low-frequency rTMS protocols targeting different brain regions such as dorsolateral prefrontal cortex or ventromedial prefrontal cortex. Personalized approaches tailored to each patient’s unique needs would benefit from treatments rather than adopting a one-size-fits-all strategy.

Integration into Standard Treatment Protocols

To maximize the potential of TMS as an effective treatment for addiction, it is essential to consider how this innovative therapy can be incorporated into existing protocols. Combining TMS with other evidence-based treatments may enhance its overall effectiveness in addressing both the addicted brain and associated withdrawal symptoms. Additionally, further research should focus on determining optimal parameters for TMS interventions (e.g., frequency, intensity) to maximize benefits.