Repetitive transcranial magnetic stimulation for alcohol use disorder – can parameter selection be leveraged to optimise treatment?

As technology rapidly advances, the evidence for the efficacy of brain-based therapeutics, such as repetitive transcranial magnetic stimulation (rTMS), for the treatment of numerous neurological and neuropsychiatric conditions continues to grow. Indeed, promising therapeutic results to date have led to several international regulatory bodies approving the use of rTMS for the treatment of depression, tobacco smoking cessation, migraines and obsessive-compulsive disorder. This is encouraging, as the use of rTMS could be successfully expanded to treat other indications such as alcohol use disorder. This review outlines the current clinical literature on the use of rTMS to treat alcohol use disorder with a focus on rTMS parameters. We aim to understand if stimulation parameter flexibility may open the door to tailored treatment for alcohol use disorder. We emphasize that whilst rTMS presents as a promising new therapeutic option for alcohol use disorder, the current evidence for its efficacy and our understanding of optimal treatment parameters are limited. Finally, we highlight the gaps that need to be filled when considering the use of rTMS to treat alcohol use disorder.