"CDC Report Shows Largest One-Year Increase in Youth Suicide Rate in 15 Years" reads the headline of a recent press release from the Centers for Disease Control and Prevention.

The CDC notice points out that, after a decline of 28 percent over 13 years, the suicide rate for 10- to 24-year-olds increased by 8 percent from 2003 to 2004.

Is this increase in suicides among young people perhaps due to the FDA's warnings to physicians and parents about a possible connection between SSRIs and suicide in young people?

I have written before about the 2004 decision by the FDA to extend its child and adolescent black-box warning to include young adults up to age 24. This new warning was in response to the concern that suicidal thinking and self-harm may increase among those young people taking antidepressants.

The issue is complicated, however, by the fact that antidepressants are prescribed for people who are already more vulnerable to suicidal thinking due to their psychiatric symptoms.

Understandably, many health care professionals worry that the FDA-mandated, black-box warning could inhibit doctors from prescribing antidepressants for young people with depression. Less treatment with SSRIs could then mean more depression and actual suicides. Several reports suggest that this is exactly what might be happening.

In one study, researchers investigated the decrease in prescriptions for SSRI antidepressant for young people in the U.S. and The Netherlands. From 2003 to 2005, there was a 22 percent decrease in SSRI prescriptions in both countries. The youth suicide rates during this same period rose 14 percent in the U.S. and 49 percent in the Netherlands.

It is hard to blame the FDA warning directly. There are many influences on mood and behavior. The use of antidepressants, however, is definitely much lower now in children and adolescents following the agency's warning. So it is possible that the black-box warning may be having the wrong effect in some young people's lives — instead of greater safety, there may now be greater risk.

What's important here is to identify young people who are experiencing depression and suicidal thinking, and to make sure that they are effectively treated — including with the appropriate use of antidepressants.

The warning on the box states "to watch closely for increased suicidal thinking." That's fine, as long as it doesn't lead to a decrease in or total lack of appropriate treatment.