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Phase II Trial: TMS Reduces Cocaine Use in Patients Pursuing Abstinence

A 180-patient Phase II trial reported reduced self-reported cocaine use and craving following a four-week course of left dorsolateral prefrontal cortex TMS in patients pursuing abstinence.

Clinical Trials October 8, 2025 · JAMA Network Open ↗

A 180-patient Phase II trial of transcranial magnetic stimulation in patients with cocaine use disorder reported significant reductions in both self-reported cocaine use and craving following a four-week course of left dorsolateral prefrontal cortex TMS. Urine drug screens corroborated the self-report findings.

At four weeks, 39% of patients in the active arm achieved at least four consecutive weeks of cocaine-negative urine screens versus 18% in sham. Craving scores dropped by approximately half in the active arm. All patients received standard psychosocial support during the trial.

The trial adds to a growing body of evidence supporting TMS in stimulant use disorders, where pharmacological options remain limited. A Phase III confirmatory trial is being planned with NIDA funding. FDA clearance is not yet pending.

Clinically, TMS for substance use disorders is currently delivered off-label at a small number of academic and specialty centers. Insurance coverage is rare. The authors stress that TMS is intended as an adjunct to psychosocial treatment, not a standalone intervention.

Source

Reporting based on coverage from JAMA Network Open. This article is editorial summary intended for general information; it is not medical advice.

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