{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:29:04Z","timestamp":1786386544198,"version":"build-2736575974"},"reference-count":58,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T00:00:00Z","timestamp":1786147200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Use &amp; Addiction Journal"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cocaine use disorder (CUD) presents high relapse rates and limited treatment options. Repetitive transcranial magnetic stimulation (rTMS) has shown promise, but evidence in clinical practice is scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a naturalistic retrospective study using medical records of patients with CUD (n\u2009=\u200993) who received rTMS treatment in a private clinic between October 2018 and 2021. Thirty-two (rTMS) sessions were administered: 2 daily sessions in the first week and 2 sessions per week at a high-frequency (10\u2009Hz) stimulation at 120% motor threshold to the left dorsolateral prefrontal cortex. Sociodemographic data, cocaine use, and treatment dropout were recorded, along with psychopathological assessments at 5 time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Baseline abstinence predicted lower relapse risk at days 5, 30, and 90 (OR range\u2009=\u20091.42-1.95, all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). At study end, abstinence probability was 58.6% for baseline abstinent versus 33.6% for active users. Intensive treatment (day 5) increased abstinence by 18.8%. Treatment completion was 44.6%, higher among baseline abstinent (70.3% vs 25.0%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Age predicted relapse (OR\u2009=\u20091.06,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.003), while sex and baseline craving did not. Craving decreased significantly over time (\n                      <jats:italic toggle=\"yes\">F<\/jats:italic>\n                      \u2009=\u200956.4,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), with higher scores in active users and a significant time\u2009\u00d7\u2009consumption interaction (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05). Sleep quality, depressive symptoms, and anxiety also improved (all\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). No side effects were described.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>rTMS was associated with reduced craving and improved clinical outcomes. Baseline abstinence and younger age were associated with lower relapse rate and increased retention. rTMS may be a safe and promising adjunctive treatment for CUD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/29767342261469368","type":"journal-article","created":{"date-parts":[[2026,8,8]],"date-time":"2026-08-08T07:00:19Z","timestamp":1786172419000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Repetitive Transcranial Magnetic Stimulation for Cocaine Use Disorder: An Observational Study"],"prefix":"10.1177","author":[{"given":"Laia","family":"Miquel","sequence":"first","affiliation":[{"name":"Health and Research, Addiction Unit of Hospital Clinic of Barcelona, Spain"},{"name":"IDIBAPS, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Folch-Sanchez","sequence":"additional","affiliation":[{"name":"IDIBAPS, Barcelona, Spain"},{"name":"University of Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4820-3937","authenticated-orcid":false,"given":"Pilar","family":"Lusilla-Palacios","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Bonanova (Barcelona), Spain"},{"name":"Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain"},{"name":"Autonomous University of Barcelona, Spain"},{"name":"Psychiatry Department, Vall d\u2019Hebron University Hospital of Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Gual","sequence":"additional","affiliation":[{"name":"IDIBAPS, Barcelona, Spain"},{"name":"Cl\u00ednica Bonanova (Barcelona), Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,8]]},"reference":[{"key":"e_1_3_2_2_2","volume-title":"European Drug Report 2023: Trends and Developments","author":"European Monitoring Centre for Drugs and Drug Addiction","year":"2023","unstructured":"European Monitoring Centre for Drugs and Drug Addiction. 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