Long-lasting efficacy of rTMS in Cocaine Use Disorder

Cocaine Use Disorder (CUD) presents a major public health challenge, with limited effective treatment options. Repetitive Transcranial Magnetic Stimulation (rTMS) has emerged as a promising neuromodulatory intervention for substance use disorders, including CUD. Several studies have demonstrated the short-term efficacy of rTMS in reducing drug use and improving psychometric associated features, though its long-term effects remain less explored. This presentation will discuss recent findings on the sustained efficacy of rTMS in individuals with CUD, focusing on neurobiological mechanisms, different approaches and clinical outcomes. We will underlie the pivotal role of dopaminergic transmission in mediating the neuroplasticity-driven mechanism of action of rTMS. We will also discuss the importance of a maintenance treatment for consolidating the efficacy of rTMS, since addiction is a chronic disease characterized by a high rate of relapse. Additionally, we will show data from an Italian Public Service which has been employing rTMS to treat CUD for 3 years. rTMS is a viable, long-term, therapeutic strategy for CUD; understanding and boosting the long-lasting efficacy of rTMS in CUD can contribute to the development of more effective, evidence-based addiction treatments.