Mohammad Ali Shenasa, Maryam Soltani, Victor Tang, Cory R. Weissman, Lawrence Gregory Appelbaum, Zafiris J. Daskalakis and Dhakshin Ramanathan
Repetitive transcranial magnetic stimulation (rTMS) is a well-established treatment with efficacy for several psychiatric disorders and has yielded promising yet mixed data…
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 To the best of the authors’ knowledge, this is a novel and unpublished endeavor.
Details
Keywords
Rebecca L. Gardner, Ellen Calhoun and Jeanne E. Boyle
In 1990 we compiled an annotated bibliography of official state lists of endangered, threatened, and rare species. In gathering information for that bibliography, which appeared…
Abstract
In 1990 we compiled an annotated bibliography of official state lists of endangered, threatened, and rare species. In gathering information for that bibliography, which appeared in Reference Services Review in Spring 1991, we found numerous unofficial sources of state lists, such as those developed by universities, institutes, and Natural Heritage Programs, which also provide valuable information on statuses of endangered, threatened, and rare species. A comprehensive search for unofficial lists results in this second bibliography.