Treating Stimulant Addiction With Repetitive Transcranial Magnetic Stimulation

Inclusion Criteria:

* SCID confirmed diagnosis of SUD, severe
* Last use of stimulants \>1 and \<6 weeks
* Stable medication regimen (no change in dose or agents between 2 weeks prior to the start of and throughout the treatment phase of the study)
* Stable social environment and housing to enable regular attendance at clinic visits.
* Ability to undergo cognitive testing, fMRI scans, and rTMS (no contraindications)
* IQ \> 80
* Stable medical health
* Veteran at Palo Alto VA's Addiction Treatment Services

Exclusion Criteria:

* Pregnant or lactating female
* History of prior adverse reaction to TMS
* On medications thought to significantly lower seizure threshold, e.g.:

* clozapine
* chlorpromazine
* clomipramine
* bupropion \> 400 mg/day
* Use of direct dopaminergic antagonists or agonists
* History of seizures 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 with study procedures, e.g. unstable angina
* Unstable psychiatric symptoms that precludes consistent participation in the study, e.g.:

* active current suicidal intent or plan
* severe psychosis
* Inability to undergo fMRI scan, e.g. claustrophobia, presence of ferromagnetic objects in subject's body
* Other substance use disorder not in sustained remission
* Chronic or recurring Axis I psychiatric condition preceding SUD other than PTSD