The use of TMS in addiction psychiatry has gained more popularity in the recent several years after the FDA had granted the use of its approval in treating Major Depressive Disorder. TMS has been studied extensively at various research institutions, including in the United States and abroad, as a promising modality to help addicted individuals achieve freedom from their chemical slavery. There is a variety of literature suggesting that TMS, when applied accurately, has potential to treat various drug addictions, including cannabis, cocaine, methamphetamines, tobacco, and possibly alcohol. It has always been the rule of thumb in addiction psychiatry to jointly use various modalities available to the physicians and other providers in order to achieve the best outcome. Frankly speaking, addiction psychiatry, unlike its mainstream general psychiatry counterpart, does not enjoy the same number of tools in the toolbox, figuratively speaking, to help the population it serves. More to the point, some classes of medications that have found wide use in psychiatry, mainly benzodiazepines, including Xanax and Valium, are all but discouraged in the field of addictions due to their habit-forming properties. Some addictions, including alcoholism and opioid use disorder, including heroin addiction, have more treatment options than others. Such prevalent habituated disorders, including the unfolding epidemic of cannabis use in California, cocaine, and methamphetamines, have not, until recently, had successful treatment options besides therapeutic interventions and symptomatic treatment, such as addressing insomnia in patients with active cocaine use or treating the post-methamphetamine “crash” with antidepressants. There is convincing clinical data that TMS can be helpful and should be tried in cases where no improvements have been gained from the use of more traditional methodologies. When we see that no improvement has been gained, we are speaking in terms of weeks, not months or years, there is absolutely no reason to wait, letting the patient waste their life and the life of their family, helplessly expecting an outcome that everyone desires. The early-on decision to use every avenue available, including medication management, sobriety programs, peer support, and TMS, is imperative in the majority of cases, including the most complicated ones. In fact, cases of dual-diagnosis nature, i.e. patients who have both chemical dependency and an underlying mood or anxiety disorder, TMS can be equally effective for both aspects of the patient’s clinical picture, due to its ability to be used both in affective disorders such as bipolar or depression, as well as in addiction. If a cliché phrase, killing two birds with one stone, appeals to you, this is probably the best way to describe what to expect from TMS.

 

TMS is a relatively recent development. It was approved by the FDA for the treatment of Major Depressive Disorder in 2007 and came to full use approximately five years ago. Due to its recent nature and the complexity of the technology behind it, including the cost of equipment, there are and will always be a select few programs that offer this treatment. When we speak about addiction psychiatry, the clinics that offer this treatment will be even more limited, due to the small amount of dual-board certified providers who specialize in addiction psychiatry, let alone those who have experience with TMS.

 

Like with any new technology, previous experience is paramount to its success. Dr. Sivtsov began to utilize TMS for the treatment of depression close to two years ago. Even though this does not seem to be much, he has already treated over 100 patients, many of whom have made a full remission. They continue to be followed by him and his outcomes show sustainability of this approach. If you are interested in exploring TMS for you or your loved one who suffers from an addiction disorder, mood disorder, or an anxiety disorder, please do not hesitate to call.