10 Hz repetitive transcranial magnetic stimulation for nitrous oxide dependence: a case report
Liang Lv, Xiao-Yu Zhang
Frontiers in Psychiatry November 6, 2026 DOI: 10.3389/fpsyt.2026.1976110 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 21-year-old woman with nitrous oxide dependence |
| Intervention | Repetitive transcranial magnetic stimulation (rTMS) |
| Dose | 10 sessions of 10 Hz rTMS |
| Duration | 10 rTMS sessions; 3-month (12-week) abstinence follow-up |
| Topics | Addiction |
| Key findings | In this single case, 10 sessions of 10 Hz rTMS over the left dorsolateral prefrontal cortex were followed by a decline in nitrous oxide craving after the third session, further improvement after the sixth, and largely resolved dependence by the end of treatment. The patient remained abstinent for three months (12 weeks) after discharge, and the authors suggest rTMS may reduce craving in the short term. |
Abstract
Nitrous oxide (N 2 O) abuse has emerged as an increasingly serious public health concern, yet effective interventions for N 2 O dependence remain lacking. We report on a 21-year-old woman with N 2 O dependence who, after 6 months of repeated N 2 O inhalation, developed gait instability, limb numbness and tremors, accompanied by delusions and auditory hallucinations. During her first hospitalization, she was treated with antipsychotics and vitamin B12; however, she relapsed to N 2 O use shortly after discharge and was readmitted. Upon her second admission, she received 10 sessions of 10 Hz repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex. Her craving for N 2 O began to decline after the third session and continued to improve after the sixth, with dependence largely resolved by the end of the treatment course. No adverse events, such as headache or tinnitus, and no significant withdrawal symptoms were observed during treatment. The patient was followed up 3 times after discharge and had maintained abstinence from N 2 O for 3 months (12 weeks) since her last use, remaining emotionally stable and resuming normal daily life and work. To our knowledge, this is the first reported case of high-frequency rTMS for N 2 O dependence. Our findings suggest that rTMS may reduce craving in the short term in these patients, offering a promising therapeutic approach to this escalating public health problem.
Comparable studies
Other case reports and case series on addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Ecstasy (MDMA) dependence Individuals meeting criteria for MDMA dependence | 1999 | Case series | n = 3 |
| Potential Human Neurotoxicity of MDMA (‘Ecstasy’): Subjective Self-Reports, Evidence from an Italian Drug Addiction Centre and Clinical Case Studies Polydrug consumers attending a Public Health Addiction Treatment Unit in Italy | 2000 | Review and clinical case series | |
| A case report SPECT study and theoretical rationale for the sequential administration of ibogaine and 5-MeO-DMT in the treatment of alcohol use disorder. 31-year-old male military veteran with moderate alcohol use disorder | 2018 | Case study | n = 1 |
| LSD Overdoses: Three Case Reports Three individuals who experienced accidental LSD overdose | 2020 | Case series | n = 3 |
| Remission of Severe Opioid Use Disorder with Ibogaine: A Case Report. 37-year-old female with severe opioid use disorder | 2016 | Case study | n = 1 |