Evaluating the Impact of Adjuvant Repetitive Transcranial Magnetic Stimulation with Usual Care vs Sham rTMS with Usual Care on Alcohol Craving in Patients with Alcohol Dependence Syndrome A Randomized Controlled Trial is a clinical study designed to examine the efficacy of rTMS as an adjunctive treatment in reducing alcohol craving among adults aged 18 to 60 years diagnosed with Alcohol Dependence Syndrome. Conducted at a tertiary care hospital in Western Maharashtra, the trial randomizes 150 participants into two groups active rTMS and sham stimulation with each receiving ten daily sessions 10 Hz, 1000 pulses per session over the left dorsolateral prefrontal cortex. Participants are assessed using the Alcohol Craving Questionnaire NOW at baseline, on day 11, and at 1 and 3 month followups. The intervention is grounded in neurobiological evidence that dysregulated prefrontal-limbic circuits drive craving and relapse. Studies by Harel et al and a 2025 meta-analysis by Treiber et al demonstrate that more than 10 sessions of high-frequency rTMS significantly reduce craving, with effects persisting up to three months. This project aims to generate robust Indian data on the effectiveness and sustainability of rTMS in relapse prevention, potentially integrating this non-pharmacological neuromodulation technique into standard care for alcohol dependence.