Accelerated brain stimulation shows early promise for meth use disorder

A small feasibility trial is offering a glimmer of hope for one of addiction medicine's toughest challenges. Researchers tested an accelerated course of repetitive transcranial magnetic stimulation (TMS) — specifically intermittent theta burst stimulation (iTBS) — in people with moderate-to-severe methamphetamine use disorder and co-existing depression. The intensive protocol involved 50 sessions over just 3 weeks, and after 12 visits, participants reported reduced methamphetamine cravings and lower depression severity.

The results are preliminary but encouraging: 94.7% of participants completed at least 45 of the 50 sessions — a notably high adherence rate for this population. Researchers borrowed elements from the SAINT protocol, originally developed for treatment-resistant depression, adapting it for stimulant use disorder.

By the Numbers:

• Overdose deaths involving methamphetamine have increased 6- to 7-fold in less than a decade
• 94.7% of participants completed ≥45 of 50 TMS sessions
• Only 13.6% of patients on the best available drug combo (naltrexone + bupropion) showed negative urine samples at 6 weeks vs. 2.5% on placebo
• 0 FDA-approved treatments currently exist for methamphetamine use disorder

Why it matters: With meth-related overdose deaths climbing and no approved pharmacological treatments on the market, even early signals from non-drug interventions like accelerated TMS are significant. A larger, multisite randomized controlled trial is the critical next step.