Can TMS And Ketamine Be Used to Treat Addiction??Can TMS And Ketamine Be Used to Treat Addiction??
Addiction Medicine Made Easy
Dr Casey Grover and Dr Philip Yam discuss how TMS and ketamine may help people with treatment-resistant depression, suicidality and substance use disorders. They explain the mechanisms, benefits, risks and practical considerations for using these neuroplasticity-based treatments in acute and addiction care.
37:12•26 Oct 2026
TMS, Ketamine and Addiction: Brain-Based Tools for Tough Cases
Episode Overview
- TMS can target specific brain regions such as the prefrontal cortex and insula to improve depression, PTSD, ADHD and nicotine addiction, with strong evidence for treatment-resistant cases.
- Addiction is framed as a brain network problem where executive function is weakened and craving networks dominate, making dual diagnosis treatment essential rather than optional.
- Ketamine at controlled, low doses can rapidly reduce depressive symptoms and suicidal thoughts by boosting glutamate and promoting neuroplasticity, but requires careful monitoring due to its abuse potential.
- Clinic-based IV ketamine and time-limited courses (such as six infusions over two weeks) are presented as safer than unsupervised or long-term use, especially for people with addictive histories.
- Combining TMS and ketamine in structured courses may enhance results for some patients, with TMS strengthening neural circuits while ketamine increases the brain’s capacity to change.
“TMS is a way to reconnect those healthy channels and highways, and then the medication has somewhere to go.”
How do people manage co-occurring mental and physical health issues while recovering? This conversation between emergency-physician-turned-addiction-doctor Dr Casey Grover and psychiatrist Dr Philip Yam zooms in on two hot topics in mental health and addiction care: transcranial magnetic stimulation (TMS) and ketamine. Aimed at clinicians and anyone curious about evidence-based treatment, the episode keeps things plain and practical.
Dr Yam breaks down TMS in simple terms, explaining how “we can actually send electrical signals targeted to reset the brain” by stimulating specific areas like the prefrontal cortex and insula. He links this to depression, PTSD, ADHD and, crucially, substance use disorders, describing addiction as a problem of damaged brain networks and weakened executive function. For people working with dual diagnosis, this session will feel familiar.
Dr Grover notes that in his practice “95 to 98%” of patients have both substance use and mental health issues, and the pair repeatedly highlight how treating depression, anxiety or PTSD can reduce cravings and relapse. You’ll hear how TMS is already FDA-cleared for nicotine addiction and how targeting the insula may help with a wide range of substance and behavioural addictions. Ketamine gets the same clear-eyed treatment.
Dr Yam walks through dosing, mechanisms and safety, stressing that in clinic “we’re not actually looking to get anyone euphoric… we’re looking for the effect of ketamine tomorrow and the rest of the week.” He also acknowledges ketamine’s abuse potential and ketamine bladder, making this especially relevant for addiction specialists wary of prescribing it. Throughout, the tone stays calm, honest and slightly nerdy in the best way, with Dr Grover openly rethinking his own referral habits.
If you’re juggling treatment-resistant depression, suicidality and substance use in an acute care setting, this chat may prompt you to ask: is it time to add TMS or ketamine to the toolkit?
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