Utilizing repetitive transcranial magnetic stimulation in the management of gambling disorder in Indonesia: protocol for a pilot and feasibility study.

Gambling disorder (GD) has emerged as a significant concern in Indonesia, particularly due to the rise in internet-based gambling during the pandemic and the limited availability of treatment options and support services for affected individuals. This issue has had profound impacts on individuals, their families, and society as a whole. Research has demonstrated that cognitive-behavioral therapy (CBT) is an effective treatment for GD. Additionally, as a relatively novel intervention, several studies have explored the efficacy of repetitive transcranial magnetic stimulation (rTMS) in addiction management, specifically in reducing cravings. This study aims to determine the potential effectiveness and feasibility of combining these two modalities within the Indonesian population. A pilot study of 10 subjects will be conducted to evaluate the effectiveness and feasibility of multimodalistic therapy using rTMS and CBT for GD. South Oaks Gambling Screen (SOGS) will be used to determine the presence of pathological gambling, and the participants will be assessed periodically using SOGS, Gambling Symptoms Assessment Scale (G-SAS), Gambling Urge Scale (GUS), Gambling Related Cognitions Scale (GRCS), Clinical Global Impression (CGI), Self-Reporting Questionnaire-20 Item (SRQ-20), Patient Health Questionnaire-9 Item (PHQ-9), and cognitive assessment. The treatment regimen will consist of 15 sessions of rTMS and 12 sessions of CBT, administered over a 5-week period. The findings of this study will contribute to the development of an optimized rTMS protocol in combination with CBT for the treatment of GD in Indonesia. Clinical trial registration: ClinicalTrials.gov https://clinicaltrials.gov/study/NCT06598501, identifier NCT06598501.