EFFICACY AND SAFETY OF TRANSCRANIAL MAGNETIC STIMULATION IN THE TREATMENT OF COCAINE USE DISORDER: AN INTEGRATIVE REVIEW

Abstract

Introduction: Cocaine Use Disorder (OCD) is one of the greatest public health challenges, with high relapse rates and absence of approved pharmacological treatments. Conventional methods, such as cognitive behavioral therapy (CBT), show limited effectiveness, making it necessary to search for alternative approaches. Transcranial Magnetic Stimulation (TMS) has emerged as a promising tool, acting on the modulation of brain circuits involved in inhibitory control and craving, essential factors for the success of the treatment of TEC. Objective: This integrative review aimed to evaluate the efficacy and safety of TMS in the treatment of TUC, identifying its impacts on the reduction of craving, cocaine consumption, and neurophysiological modulation. Methodology: The search was carried out in scientific databases (PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library), including studies published between 2013 and 2023. Randomized clinical trials, systematic reviews, and observational studies that investigated the application of TMS in individuals with OCD were analyzed. The inclusion criteria included surveys with human samples and quantitative evaluation of the effects of TMS on the consumption of the substance. Results: The findings indicate that high-frequency TMS (≥10 Hz) applied to the left dorsolateral prefrontal cortex (DLPFC) promotes a significant reduction in craving and cocaine consumption, as well as improvements in inhibitory control and impulsivity. The safety of the treatment was widely confirmed, with mild and transient adverse effects, such as headache and discomfort at the application site, with no serious events recorded. However, methodological heterogeneity, variation in stimulation protocols, and lack of standardization of outcomes make it difficult to make direct comparisons between studies. Conclusion: TMS presents itself as an innovative and safe therapeutic alternative for the treatment of TUC, especially for patients resistant to conventional approaches. However, for it to be consolidated as a clinical treatment, greater methodological rigor is needed, with more robust randomized clinical trials, standardization of stimulation protocols, and inclusion of neurophysiological biomarkers. In addition, future studies should explore the integration of TMS with conventional approaches, such as CBT, to enhance its therapeutic effects and expand its clinical applicability.

DOI: https://doi.org/10.56238/sevened2024.039-027