283. REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION (RTMS) IN THE MANAGEMENT OF ALCOHOL DEPENDENCE AND OTHER SUBSTANCE ABUSE DISORDERS – EMERGING DATA AND CLINICAL RELEVANCE

Abstract Background Repetitive transcranial magnetic stimulation (rTMS) has been used widely in various psychiatric disorders like depression and schizophrenia. There have been some reports of its usefulness in alcohol dependence and substance use disorders. Aims & Objectives The present paper reviews the studies done using rTMS in substance use disorders including alcohol and nicotine dependence. Method Various studies done have been reviewed including the proposed mechanisms of action are outlined with the future research needs and need for further clinical data. Clinic based personal experience of the author and the role of rTMS in relapse prevention on its own and in combination with medication are discussed. Results rTMS has been proven in studies to reduce smoking and reduce alcohol craving in patients with alcohol dependence. The impact of different treatment protocols, strength of stimulation and duration and frequency are discussed. Discussion & Conclusions Transcranial magnetic stimulation has provided a safe and non-invasive method to evaluate the neurophysiology of the human cortex. TMS paradigms have demonstrated alterations in cortical excitation in chronic cocaine, nicotine, and alcohol users. Moreover, rTMS has been reported to modulate neurotransmission, and early studies suggest that it may be a promising treatment for a number of substance abuse disorders.