The Effect of Transcranial Direct Current Stimulation on Relapse, Anxiety, and Depression in Patients With Opioid Dependence Under Methadone Maintenance Treatment: A Pilot Study

Abstract

Background and Objective: Patients under methadone maintenance therapy (MMT) are susceptible to several complications including mental disturbances and risk of relapse. The present study was designed to evaluate the effects of tDCS on relapse, depression, and anxiety of opioid-dependent patients under methadone maintenance treatment (MMT). Methods: It was a randomized-clinical trial that conducted among 27 male patients referred to the outpatient addiction clinic of Ibn-e-Sina psychiatric hospital in Mashhad from July 2018 to May 2019. Participants were allocated to two treatment groups including intervention and sham groups. The intervention group received seven sessions of tDCS, in the F3 (cathode) and F4 (anode) areas of the brain, each one lasts 20 min, in two consecutive weeks. Depression, anxiety, and stress scale-21 (DASS-21) were measured before, during, and after the intervention in patients under MMT. Relapse on the morphine, cannabis, and methamphetamine was screened by urine dipstick tests of morphine, cannabis, and methamphetamine. Results: Depression, anxiety, and stress of participants were significantly reduced in the intervention group compared with the control after the seventh session of tDCS (P < 0.001, P=0.01, and P=0.01, respectively). In addition, the relapse rate showed no significant changes between the two groups (P=0.33). Conclusion: Overall, our study demonstrated that depression, anxiety, and stress of participants were significantly reduced after the seventh session of tDCS, but did not affect

Adjunctive High-Definition Transcranial Direct Current Stimulation in Brain Glutamate-Glutamine and γ-Aminobutyric Acid, Withdrawal and Craving During Early Abstinence Among Patients With Opioid Use Disorder on Buprenorphine-Naloxone

“…16,18 Most of them had completed high school education, which is consistent with other studies. [16][17][18] A majority of participants were unmarried like in an earlier study 17 but unlike in others. 17,18 A majority of them were unemployed like a recent study, 18 whereas in another earlier study, most of the participants were employees or self-employed.…”

“…[16][17][18] A majority of participants were unmarried like in an earlier study 17 but unlike in others. 17,18 A majority of them were unemployed like a recent study, 18 whereas in another earlier study, most of the participants were employees or self-employed. 16 The mean SDS score and COWS baseline score indicate a relatively higher severity of dependence and withdrawal among participants at baseline.…”

“…14 To the best of the authors' knowledge, only 3 studies have examined the efficacy of tDCS in opioid craving. [15][16][17][18] Furthermore, a recent review did not find any study on use of tDCS during withdrawal and detoxification phase of treatment. 19 Two of these studies include patients with methadone maintenance treatment.…”

“…19 Two of these studies include patients with methadone maintenance treatment. 16,18 These studies were limited by their reliance on self-report and psychological measure as outcome measurement. To the best of the authors' knowledge, no study has examined the effect of HD-tDCS in opioid craving and withdrawal, and brain glutamate-glutamine (Glx) and γ-aminobutyric acid (GABA) as measured by 1 H-MRS among patients on BPN during the early abstinence period.…”

“…Another 1 H-MRS study found a different frontal metabolite profile in opioid dependence 14 . To the best of the authors' knowledge, only 3 studies have examined the efficacy of tDCS in opioid craving 15–18 . Furthermore, a recent review did not find any study on use of tDCS during withdrawal and detoxification phase of treatment 19 .…”