Does adding high-frequency rTMS and exercise reduce negative emotions in methamphetamine use disorder?
Negative emotions like depression and anxiety are common during withdrawal from methamphetamine and can increase the risk of relapse. A 2024 randomized trial tested whether combining high-frequency repetitive transcranial magnetic stimulation (rTMS) with physical exercise could reduce these negative emotions more than exercise alone. The answer is yes: the combination led to greater reductions in depression, anxiety, and craving, and also improved neurotransmitter levels linked to mood regulation.
What the research says
A 2024 randomized clinical trial involving 54 male patients with methamphetamine use disorder compared three groups: exercise alone, high-frequency rTMS (10 Hz over the left dorsolateral prefrontal cortex) combined with exercise, and a control group receiving only health education 7. All interventions were given three times per week for 12 weeks (8 weeks of intervention plus 4 weeks of follow-up) 7. The rTMS+exercise group showed significantly greater reductions in depression, anxiety, and methamphetamine craving compared to the exercise-only group and the control group 7. Additionally, the combined group had more favorable changes in blood neurotransmitters, including increased dopamine and serotonin, which are important for mood regulation 7. These findings align with a broader network meta-analysis of 53 studies that identified both exercise and TMS as effective non-pharmacotherapies for reducing craving in methamphetamine use disorder 1. The meta-analysis specifically noted that 10 Hz rTMS targeting the left dorsolateral prefrontal cortex and combined aerobic/resistance exercise were among the most effective protocols 1. Another study found that yoga with mindfulness improved sleep, anxiety, and physical function in methamphetamine addicts, suggesting that mind-body interventions may also help 6. However, the 2024 trial is the first to directly test the combination of rTMS and exercise for negative emotions in this population 7.
What to ask your doctor
- Could high-frequency rTMS combined with exercise be an option for managing my withdrawal symptoms?
- Are there any rTMS clinics or programs nearby that offer this treatment for substance use disorders?
- What type and duration of exercise would be safe and effective for me during recovery?
- How do I know if I am a good candidate for rTMS, and are there any side effects I should watch for?
- Should I consider other non-pharmacological approaches like yoga or mindfulness to help with mood and cravings?
This question is drawn from common patient questions about Psychiatry and answered using cited medical research. We do not provide individualized advice.