Unexpected improvement in nicotine consumption after low-frequency repetitive magnetic stimulation

Abstract

Background We report a case on the efficiency of low-frequency repetitive transcranial magnetic stimulation (rTMS) on cigarette consumption cessation. The patient was 29 years old, He received intensive psychiatric treatments along with ten years of history of depressive and obsessive-compulsive disorders. The first four years of treatment were marked by good outcomes. However, the last 6 years were marked by persisting depressive symptoms associating with psychotic features and sexual obsessions. Methods The patient received 20 sessions of rTMS over two weeks, 10 times per week at 1 Hz frequency, each session lasted 20 min with 200 pulses and 100% of motor threshold. In the meanwhile, the patient continued his full drug-based treatment according to the reported prescription. Results and conclusion After 20 sessions, the patient reported a decreased severity of his depressive symptoms with a BDI (Beck Depression Inventory) score of 6 but without significant improvement of OCD with a YBOCS score of 32. However, the patient reported great improvement in his tobacco craving and a diminishing number of consumed cigarettes in the second week of the rTMS protocol of treatment. This ended with tobacco cessation within a month. However, this occurred without any medication or psychological support for treating tobacco dependence.