Repetitive Transcranial Magnetic Stimulation Treatment of Stimulant Use Disorder

The purpose of this study is to establish a new treatment (repetitive transcranial stimulation (rTMS)) for Veterans with stimulant use disorder (SUD). Despite the large public health burden imposed by SUD, there is currently no FDA-approved or widely recognized effective somatic treatment. This placebo controlled study will test the effectiveness of rTMS in the treatment of SUD, and explore biomarkers that may guide patient selection for rTMS treatment and predict treatment response.

Inclusion Criteria: * Must be a U.S. Veteran * Structured Clinical Interview for DSM Disorders (SCID) confirmed diagnosis of SUD, severe * Last use of stimulants \>2 and \ 400mg/day * Seizure disorder or conditions known to substantially increase risk for seizures * Implants or medical devices incompatible with TMS * Acute or unstable chronic medical illness that would affect participation or compliance in the study, e.g. unstable angina * Unstable psychiatric symptoms that precludes consistent participation in the study, e.g. active current suicidal intent or plan; severe psychosis * Other substance use disorder not in remission * Chronic or recurring Axis I psychotic disorders * For subjects participating in functional magnetic resonance imaging (fMRI) scans, presence of ferromagnetic material in their body or taking DAergic medications