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Long-term outcomes following repetitive transcranial magnetic stimulation (rTMS) in cocaine-use disorder (CUD)

Publication Reference

Madeo, G., Terraneo, A., Cardullo, S., Gómez Pérez, L. J., Cellini, N., Sarlo, M., … & Gallimberti, L. (2020). Long-term outcome of repetitive transcranial magnetic stimulation in a large cohort of patients with cocaine-use disorder: an observational study. Frontiers in Psychiatry, 11, 158.


Article Summary*

This retrospective, observational study investigated whether repetitive transcranial magnetic stimulation (rTMS) has efficacy in helping stop or reduce cocaine use in a cohort of 284 outpatients (268 men) who met DSM-5 criteria for cocaine use disorder (CocUD). Prior to receiving rTMS, most patients (90%) were using cocaine daily or several times per week. High frequency rTMS to the left dorsolateral prefrontal cortex was provided twice per day for 5 days, followed by once weekly (twice a day) sessions over 11 weeks. During the subsequent follow-up period rTMS was readministered on an individualized basis regarding cocaine use and cocaine cravings. The follow-up period was up to 2 years, 8 months (median follow-up = 5 months), during which regular urine screens, self-reports, and family-member reports were used to measure drug use.

Following the commencement of rTMS, the median time to the first relapse (recurrence of cocaine use) was 91 days (95% CI 70-109 days). This was compared to a ‘treatment as usual’ cohort of outpatient who had a median time to first relapse of 51 days (95% CI 39-78 days). In the rTMS cohort, most patients had rTMS re-administered weekly and then monthly, throughout the follow-up period. The gradual reduction in the re-administration of rTMS was not associated with an increase in relapse. Within a closely followed subsample (n=147; median follow-up = 7 months) the mean frequency of cocaine use was less than once a day per month (median = 0).

The authors concluded that this was the first follow-up study to show that rTMS was accompanied by long-lasting reductions in cocaine use in a large sample of patients.


*For original abstract/publication see the link below.

Publication link: Frontiers | Long-Term Outcome of Repetitive Transcranial Magnetic Stimulation in a Large Cohort of Patients With Cocaine-Use Disorder: An Observational Study | Psychiatry (

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