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Brain stimulation may help ease methamphetamine withdrawal symptoms

High-frequency repetitive transcranial magnetic stimulation targeting the left dorsal-lateral prefrontal cortex could facilitate methamphetamine detoxification, according to research published in JAMA Psychiatry.

“Currently, limited pharmaceutical tools are available for detoxification from methamphetamine; vitamins, antidepressants and antipsychotics have been used to ameliorate withdrawal symptoms in clinical practices,” Ying Liang, PhD, from the School of Social and Behavioral Sciences at Nanjing University, and colleagues wrote. “It is unknown if noninvasive brain stimulation could facilitate detoxification during the withdrawal period in humans.”

In a double-blind, randomized, parallel group trial, researchers examined whether using high (10 Hz for 10 minutes) repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsal-lateral prefrontal cortex curbed symptoms of withdrawal in 48 men with methamphetamine addiction who were randomly allocated to receive real or sham rTMS.

The intervention lasted for 10 days, with 2 days rest after the first 5 days. The investigators measured withdrawal symptoms from methamphetamine, sleep quality, depression and anxiety after treatment.

After 10 days of rTMS treatments, Liang and colleagues observed decreases in withdrawal symptoms, craving, quality of sleep and mood. For all these measures, the data showed significant difference for time and significant time × group interaction effect. For withdrawal symptoms, post hoc t tests with Bonferroni correction for multiple comparisons revealed significant reductions in both real and sham rTMS groups.

Post hoc analyses demonstrated significant reductions in craving score, sleep difficulties and depression among participants in the real rTMS group, but not for those in the sham group after applying Bonferroni correction for multiple comparisons. Further analyses that used paired-samples t tests also demonstrated that anxiety was significantly reduced for the real rTMS group, but not for the sham group. In addition, deductions in craving score was associated with reduced withdrawal symptoms, improvements in sleep and decreased severity of anxiety.

“This study further proved that rTMS acts as a prospective tool against withdrawal syndrome; therefore, the application of rTMS to patients in different stages of addiction may be expanded,” Liang and colleagues found. “Further mechanistic and longer follow-up studies are required to elucidate the long-term effects of rTMS on addiction. The potential value of the procedure should be tested in larger clinical trials and to prevent relapse from addiction.” – by Savannah Demko

Disclosure: The authors report no relevant financial disclosures.