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Suicide remains a leading cause of death for American adolescents, but over the last decade, the rate of suicide among teenagers has declined. In a new study, researchers at Columbia University suggest that this drop may be linked in part to the increasing use of antidepressant drugs in young people.

The researchers examined teenage suicide rates and prescriptions filled by children ages 10 to 19 in 588 regions of the country from 1990 to 2000. Regions with higher rates of antidepressant use in 1990 or 2000 had higher suicide rates. But over time, an increase in the use of antidepressants was associated with a decrease in suicides.

The inverse relationship between the drugs and suicide held for boys, older adolescents and lower-income teenagers but not for girls or younger adolescents.

"People have known for some time that over the last years there has been an increase in the use of antidepressants" among children, said Dr. Mark Olfson, a professor of clinical psychiatry at Columbia and the lead author of the study, published this month in The Archives of General Psychiatry. "The question we're trying to get at here is, `Has that contributed to the decline in suicide?' This provides some evidence that it may have."

But Dr. Olfson and his colleagues also noted limitations in the research methods, including its reliance on data from groups rather than individuals. Other factors, including tougher gun control laws in some regions and reduced use of alcohol and drugs, may have contributed to the drop in suicides, they said.

The relationship, if any, between suicide and S.S.R.I.'s, the newer class of antidepressants that includes Prozac, Zoloft, Paxil and other medications, is a subject of controversy. Several studies have found correlations between the increased use of the drugs in adults and decreased suicide rates in Sweden and other countries. One study, in Italy, found no link.

In recent months, questions also have been raised about whether some drugs may increase the risk of suicide in some children. British regulators, acting on the basis of unpublished data that link Paxil with suicidal thoughts and behavior in children and adolescents, warned doctors not to prescribe the drug for them. Last month, the regulators also issued a warning about a medication from Wyeth, Effexor, which they said posed a risk of hostility and suicidal thoughts in adolescents. In June, the Food and Drug Administration recommended that doctors refrain from giving Paxil to children while the agency reviews the issue.

Dr. Olfson noted that most youths who committed suicide received no treatment at all in the months before they died. He said the new study placed the concerns about Paxil and other S.S.R.I.'s, selective serotonin reuptake inhibitors, "in a broader context of a society that has substantial unmet needs for depressed young people."

Other experts said the study's findings were interesting but far from conclusive in showing a link between drug treatment and a drop in suicide.

"To me, this is just an impressionistic piece," said Dr. David A. Brent, a professor of psychiatry, pediatrics and epidemiology at the University of Pittsburgh and an expert on youth suicide. "It's like a signal. But this type of study can't prove causality."

Dr. Julie Magno Zito, an associate professor of pharmacy and medicine at the University of Maryland who has documented striking increases in the use of antidepressants for children, said she did not find the study convincing.

"It's at best very weak evidence," Dr. Zito said. "I think these findings are inconsistent with other data that have more rigorous methodology."

The researchers based their analyses on national suicide rates from the Centers for Disease Control and Prevention, as well as prescription data provided by AdvancePCS, the largest pharmacy benefit management company in the nation.

Suicide is the third leading cause of death among teenagers 15 to 19 and the fourth leading cause of death in adolescents 10 to 14. In 2000, according to the C.D.C., 4.7 adolescents per 100,000 took their own lives, compared with 6.4 per 100,000 in 1990.

In the study, a 1 percent increase in antidepressant use from 1990 to 2000 was associated with a drop of 0.23 suicides per 100,000 adolescents per year. The link was found only for S.S.R.I.'s. not for older antidepressants.

The other authors of the study, financed by the Carmel Hill Fund, and the National Institute of Mental Health, were Dr. David Shaffer and Ted Greenberg, of Columbia, and Dr. Steven C. Marcus of the University of Pennsylvania.

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