Abstract
BACKGROUND: Major depressive disorder (MDD) is a prevalent mental health condition affecting both adolescents and adults, yet age-specific differences in treatment response remain underexplored. Magnetic Seizure Therapy (MST) is an emerging neuromodulation technique for treatment-resistant depression. This study aimed to compare the efficacy, tolerability, and cognitive effects of MST between adolescents and adults with MDD. METHODS: This single-center prospective study enrolled 128 patients with MDD, including 67 adolescents and 61 adults. All participants received MST and were assessed at baseline, 72 h, and 3 months post-treatment. Clinical outcomes were evaluated using HAMD-17, HAMA, BPRS, MoCA, C-SSRS, and CGI. Group differences in treatment response, cognitive outcomes, and tolerability were analyzed over time. RESULTS: At 72 h post-treatment, adolescents had significantly lower HAMD-17 and HAMA scores (all p < 0.001) than adults, indicating faster initial improvement. By 3 months, adults reached similar symptom levels. C-SSRS decreased more in adults (p = 0.001). Analysis of MoCA subscales at 72 h revealed greater declines in delayed recall and executive function in adults, with no significant changes in adolescents (p = 0.038 and 0.039, respectively), whereas no differences were observed at 3 months. Common adverse events in adults included headache, memory decline, fatigue, and vital sign abnormalities, all less frequent in adolescents (p < 0.05); myalgia occurred only in adolescents, while dizziness and nausea/vomiting showed no group differences. CONCLUSION: MST is effective in both groups, but adolescents demonstrate faster response, better cognitive preservation, and fewer somatic side effects, supporting its use in younger patients. REGISTRY NAME: Magnetic Seizure Therapy and modified electroconvulsive therapy for the efficacy and impact on cognitive function in adolescents with treatment-resistant depression. REGISTRATION NUMBER: Not applicable.