Using brain stimulation to treat alcohol use disorder with Anastasia DeminaUsing brain stimulation to treat alcohol use disorder with Anastasia Demina
Addiction Audio
Dr Sunvei Lim interviews Dr Anastasia Demina about a large trial testing transcranial direct current stimulation for alcohol use disorder, focusing on reducing heavy drinking days. The discussion covers current medications, how tDCS works, trial results, safety, and plans for more personalised brain stimulation approaches.
20:33•31 Jul 2026
Gentle Brain Stimulation as a New Tool for Alcohol Use Disorder
Episode Overview
- Existing medications for alcohol use disorder have limited efficacy and are underused, prompting interest in alternative strategies.
- Transcranial direct current stimulation is a non-invasive, safe procedure that targets brain regions involved in cognitive control and craving.
- The Restem trial included over 330 participants focused on reducing alcohol use rather than achieving abstinence, aligning with modern treatment goals.
- Active tDCS produced a statistically significant reduction in heavy drinking days over 24 weeks compared with sham stimulation.
- Future work, including the Restem2 trial, aims to increase session frequency and personalise protocols to improve treatment effects.
“So, the question is not what treatment would be the treatment for alcohol use disorder, but which treatment could be acceptable and could be the most optimal strategy for a given individual with alcohol use disorder.”
What drives someone to seek a life without alcohol? This instalment of Addiction Audio takes that question into the clinic, focusing on brain stimulation as a potential tool for treating alcohol use disorder. Host Dr Sunvei Lim chats with Dr Anastasia Demina, an addiction physician and researcher from Dijon University Hospital and Université Bourgogne Europe, about her large phase 3 trial on transcranial direct current stimulation (tDCS).
If you’ve ever imagined brain stimulation as something out of science fiction, you’ll be reassured here: tDCS uses a weak electrical current via scalp electrodes, is non-invasive, and has an excellent safety profile. Dr Demina starts by sketching out current pharmacological options in France, including acamprosate, naltrexone, disulfiram, nalmefene and baclofen. She points out that their “efficacy profiles are suboptimal” and that they’re often underused, which opens the door for new strategies.
As she puts it, “the question is not what treatment would be the treatment for alcohol use disorder, but which treatment could be acceptable and could be the most optimal strategy for a given individual.” Her Restem trial stands out for several reasons: more than 330 participants, no abstinence requirement, and a focus on reducing consumption rather than enforcing complete sobriety.
Participants aimed to cut down rather than stop drinking altogether, reflecting a shift in modern addiction medicine towards regaining control over use. The team found a statistically significant reduction in heavy drinking days in the active tDCS group compared with sham, sustained over a 24-week follow-up without ongoing treatment. You’ll also hear about how tDCS targets the dorsolateral prefrontal cortex to support cognitive function and craving management, and why personalising stimulation protocols may be the next big step.
Dr Demina previews the Restem2 trial, which ramps up the number of sessions to test whether more intensive, clustered stimulation can boost outcomes further. If you’re interested in future-facing treatments that sit alongside traditional medications, this conversation offers plenty to think about – could gentle brain stimulation one day become part of standard care for alcohol use disorder?
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