Effect of Repetitive Transcranial Magnetic Stimulation (rTMS) on the Drug Use Craving in Patients with Methamphetamine Dependency During Withdrawal Phase: A Sham Controlled Randomized Clinical Trial

Background: Methamphetamine is considered as one of the potent psychological stimuli with high addiction capacity. Drug craving is one of the most critical factors in drug addiction, leading to drug use relapse once withdrawn. The objective of the present research was to evaluate the effect of Transcranial Magnetic Stimulation (rTMS) on the drug craving in patients using methamphetamine. Methods: This study was conducted in a double-blind sham-controlled design on 31 patients in Summer 2016. The patients were randomly assigned into 3 groups (each group comprising10 subjects) and rTMS was performed at the left Dorsolateral Prefrontal Cortex (DLPFC) with frequency of 15Hz and the left Orbitofrontal Cortex (OFC) with a frequency of 1 Hz. One day before the onset of the intervention and one week following the completion of it, the subjects were evaluated using Hamilton Rating Scale for Depression (HRSD), The Brief Psychiatric Rating Scale (BPRS), and visual cue-induced craving assessment task. In a 6-month follow up after the completion of the sessions, the patients were asked whether they tended to be hospitalized (psychiatric service, campus) for psychiatry or substance was collected in a self and family report manner by phone call. Two patients in the DLPFC group, 1 in the OFPFC, and 4 patients in the control group were hospitalized. However, these frequencies were not statistically significant (p=0.343, χ2=2.139). Results: Repetitive magnetic stimulation failed to significantly reduce craving, but in a 6-month follow up, most cases of substance related hospitalization were reported to be in the control group. Conclusion: rTMS can reduce the complications of using methamphetamine, such as the number of substance related hospitalizations.