Evidence map›Paper›PMID 40040511›Full record

Trial reportEuropean psychiatry : the journal of the Association of European Psychiatrists2025

Repetitive transcranial magnetic stimulation for the treatment of suicidality in opioid use disorder: a pilot feasibility randomized controlled trial.

Victor M Tang, Bernard Le Foll, Zafiris J Daskalakis, An-Li Wang, Leslie Buckley, Daniel M Blumberger, Daphne Voineskos

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European psychiatry : the journal of the Association of European Psychiatrists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04785456 (Repetitive Transcranial Magnetic Stimulation for Suicidality in Opioid Use Disorders), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04785456 nacompletednot on this map

Repetitive Transcranial Magnetic Stimulation for Suicidality in Opioid Use Disorders

TypeinterventionalSponsorCentre for Addiction and Mental HealthRan2022 to 2024Enrolled10ConditionsMajor Depressive Disorder, Opioid-use DisorderArmsActive TBS, Sham TBS
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Victor M TangInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.ORCID 0000-0001-5365-9683
Bernard Le FollInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-6406-4973
Zafiris J DaskalakisDepartment of Psychiatry, University of California, San Diego, CA, USA.
An-Li WangIcahn School of Medicine at Mount Sinai, New York, NY, USA.
Leslie BuckleyDepartment of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-3134-7504
Daniel M BlumbergerInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-8422-5818
Daphne VoineskosInstitute of Medical Science, University of Toronto, Toronto, ON, Canada.ORCID 0000-0002-7450-4434

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOpioid use disorder (OUD) is a devastating condition with frequent suicidality, contributing to overdose deaths. Theta burst stimulation (TBS) to the dorsolateral prefrontal cortex (DLPFC) is used to treat major depressive disorder (MDD) and is effective in treating suicidal ideation. We piloted a randomized, double-blind, sham-controlled trial of bilateral rTMS for patients with OUD and MDD experiencing suicidality.

methodsSequential bilateral TBS was delivered guided by structural neuroimaging: continuous TBS to the right then intermittent TBS to the left DLPFC, daily (20 treatments). The primary objective was to determine the feasibility of this population. The primary clinical outcome was the scale for suicidal ideation (SSI), secondary outcomes included depressive symptoms and opioid cue-induced craving. ClinicalTrials.gov: NCT04785456.

resultsEighty-seven individuals were pre-screened. The most common reasons for ineligibility included being unreachable by the study team, difficulty with scheduling/travel requirements, and medical/psychiatric instability. Six participants (5:1 M:F) were enrolled (3/arm), four had a fentanyl use history; two completed per protocol (1/arm). Of the participants with follow-up data, SSI scores decreased in 2/3 in the sham arm and 2/2 in the active arm; depression and opioid craving scores decreased in all participants.

conclusionWe present the first data piloting a structural neuroimaging-guided, multi-session rTMS treatment course in outpatients with suicidality and OUD in the current North American context. Recruitment and retention were the main challenges given the highly unstable medical and psychosocial context of this patient population. Future trials should consider a suitable environment to improve the feasibility of delivering this treatment.

Indexed as

Dorsolateral Prefrontal CortexMajor Depressive DisorderOpioid-Related DisordersOutcome Assessment, Health CareSuicidal IdeationTranscranial Magnetic StimulationAdultCravingDouble-Blind MethodFeasibility StudiesFemaleHumansMaleMiddle AgedPilot Projectsmajor depressive disorderopioid use disordersuicidetheta burst stimulationtranscranial magnetic stimulation

Identifiers

PMID40040511
PMCPMC12188329

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.