Monday, December 27, 2021

Specific Type of TMS May Be Effective for People With Alcohol Use Disorder

A study published in Biological Psychiatry found that people with alcohol use disorder who received deep transcranial magnetic stimulation (deep TMS) reported fewer heavy drinking days and alcohol cravings than those who received a sham stimulation. Deep TMS is a form of transcranial magnetic stimulation that is capable of reaching more interior brain regions than conventional TMS.

To test the efficacy of deep TMS, Maayan Harel, Ph.D., of Ben-Gurion University in Beer Sheva, Israel, and colleagues enrolled 51 treatment-seeking adults aged 18 to 65 with moderate to severe alcohol use disorder for their trial. The participants were randomized to receive either active or sham deep TMS targeted to their medial prefrontal cortex (mPFC) and anterior cingulate cortex (ACC), two regions associated with cravings and reward behaviors. Both groups received 15 sessions over three weeks (the acute phase), then five sessions over three months (the follow-up phase).

The main study outcome was the percentage of heavy drinking days (≥4 drinks a day for women and ≥5 for men) reported by the participants during the follow-up phase. The researchers also assessed the participants’ craving levels during both the acute and follow-up phases using the Penn alcohol craving scale (PACS).

At the end of follow-up, both groups of participants experienced significant declines in the frequency of their heavy drinking days. However, the improvement was more pronounced in adults who received active TMS (2.9% heavy drinking days over 12 weeks) compared with sham TMS (10.6% heavy drinking days over 12 weeks). PACS scores also dropped significantly among both during the acute treatment period (from 14 to 5 in the active group and 16 to 8 in the sham group). During the follow-up period, PACS scores remained level for the active group but rose in the sham group.

Participants experienced no severe side effects during the study; the only notable side effect was transient headache, a common side effect of TMS.

“We believe the findings presented here represent an important advance,” wrote the authors. “[Deep] TMS targeting the mPFC and ACC appears to be a safe and well-tolerated intervention, with promising initial evidence for efficacy in alcohol addiction. A full-scale multicenter study to confirm the efficacy of this intervention appears warranted.”

To read more on this topic, see the Psychiatric News article “Can Ketamine Curb Excess Drinking?”

(Image: iStock/alvarez)

APA Joins in Negotiations Over New Clozapine REMS

Problems with the new clozapine REMS threaten delays or discontinuation of doses for patients. Here is background information on the situation and the response so far.



The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.