RESIDENT: iTBS for the Treatment of Substance Use Disorder (SUD), A Systematic Review and Network Meta-Analysis
Presenting Author(s): Raza Qadri
Co-Author(s): Gilmar Gutierrez and Yanbo Zhang
Date and time: 21 Mar 2026 from 14:15 to 14:30
Location: Saddleback & Glacier
Learning Objectives
- Explore the iTBS interventions available in the literature for the management of SUD;
- Determine how different areas of brain stimulation compare in terms of reduction in addiction symptoms; and
- Consider the benefits and potential drawbacks of iTBS compared to other available interventions for the management of SUD.
Abstract
Introduction: Substance use disorder (SUD) is a common condition characterized by compulsive drug- craving and consumption despite harmful short and long-term consequences. The challenges associated with treating SUD have highlighted the need for additional interventions. Recently, intermittent theta burst stimulation (iTBS) has become a promising treatment option for addictions.
Methods: This was a systematic review and network meta-analysis. The systematic search considered studies on iTBS for the treatment of SUD, and was conducted on six electronic databases: EMBASE, MEDLINE, SCOPUS, CINAHL, PsycINFO, and Cochrane. The extracted data was analyzed suing a meta- analytic and network meta-analytic approach. The quality of the data was assessed using validated tools.
Results: 17 studies met our eligibility criteria. These studies considered the treatment of a variety of SUDS (methamphetamine, nicotine, alcohol, opioids, and cocaine) and areas of brain stimulation. The results showed that iTBS significantly reduce substance use and craving with a medium to large effect size, and that stimulation to the left dorsolateral prefrontal cortex (LDLPFC) was more effective compared to stimulating other brain areas, for craving reduction. iTBS was overall well tolerated by the patients. The quality of the data was assessed to be moderate to low.
Conclusions: This study is the first network meta-analysis and the most comprehensive review of the literature on the use of iTBS for the treatment of SUD. The results are promising and support the effectiveness and tolerability of iTBS. This review also highlighted the scarcity of studies in this field and the need for more high-quality research.
Literature References
- Antonelli, M., Fattore, L., Sestito, L., Di Giuda, D., Diana, M., Addolorato, G., 2021. Transcranial Magnetic Stimulation: A review about its efficacy in the treatment of alcohol, tobacco and cocaine addiction. Addict. Behav. 114, 106760.
- Coles, A.S., Kozak, K., George, T.P., 2018. A review of brain stimulation methods to treat substance use disorders. Am. J. Addict. 27, 71-91.
- Ren, Z., Mu, L., Wang, L., Xia, L., Song, P., Wang, Yan, Li, J., Duan, F., Li, H., Tang, H., Wang, W., Zhu, L., Zhang, L., Song, X., Wang, Yujing, Zhao, W., Zhu, Y., Wang, Z., Shao, W., Zhang, X., Jiao, D., 2024. Predictive role of impulsivity, anxiety, and depression in the efficacy of intermittent theta burst transcranial magnetic stimulation modalities for treating methamphetamine use disorder: A randomized clinical trial. J. Subst. Use Addict. Treat. 156, 209189.