Repetitive transcranial magnetic stimulation implementation within residential substance use disorder treatment centers for patients with comorbid depression
ISSN: 1757-0972
Article publication date: 9 October 2023
Issue publication date: 23 November 2023
Abstract
Purpose
Repetitive transcranial magnetic stimulation (rTMS) is a well-established treatment with efficacy for several psychiatric disorders and has yielded promising yet mixed data showing reductions in craving for substance use. Patients with substance use disorders and comorbid depression may encounter obstacles to receiving rTMS in outpatient settings for treatment of depression. In turn, implementation of rTMS in residential substance use programs would greatly benefit those with comorbid treatment resistant depression. This paper aims to provide recommendations for implementing rTMS within residential substance use treatment centers.
Design/methodology/approach
Using PubMed, the authors conducted a narrative review of manuscripts using various combinations of the following search terms: rTMS, depression, substance use and substance use disorder. The authors read manuscripts for their methodology, outcomes and adverse events to synthesize their results, which correspond to their recommendations for patient selection, safely implementing rTMS in residential substance use facilities and optimal rTMS protocols to start with.
Findings
Advantages of this approach include increased compliance, monitoring and access to care. Recommendations to safely incorporate rTMS in residential substance use disorder treatment centers revolve around selection of patients eligible for rTMS, allowing for sufficient time to elapse prior to commencing rTMS, monitoring for signs of recent substance use or withdrawal and using rTMS protocols compatible with the therapeutic programming of a treatment center.
Originality/value
This paper details the challenges and benefits of implementing rTMS for patients with dual diagnosis and provides recommendations to safely do so. To the best of the authors’ knowledge, this is a novel and unpublished endeavor.
Keywords
Acknowledgements
Competing interests: Z.J.D. is on the scientific advisory board and receives research support from Brainsway Inc. Z.J.D. receives equipment support for research from MagVenture Inc. M.A.S., M.S., V.T., C.R.W., L.G.A. and D.R. declare no competing or conflicts of interest.
Citation
Shenasa, M.A., Soltani, M., Tang, V., Weissman, C.R., Appelbaum, L.G., Daskalakis, Z.J. and Ramanathan, D. (2023), "Repetitive transcranial magnetic stimulation implementation within residential substance use disorder treatment centers for patients with comorbid depression", Advances in Dual Diagnosis, Vol. 16 No. 4, pp. 209-217. https://doi.org/10.1108/ADD-03-2023-0008
Publisher
:Emerald Publishing Limited
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