In October of 1993, the FDA responded to anecdotal reports of a small number of suicides by teenagers who were taking antidepressants (primarily Paxil) for depression by issuing a public health advisory about the possible link between the use of SSRIs and adolescent suicide, stating that “antidepressant drugs could increase the chances of suicidal thoughts or actions in children and teenagers.” This warning received much attention and appeared to have substantial impact on parents and doctors by inhibiting prescription of antidepressants for children and adolescents.

This impact was underscored by a report released in September of 2007 by the U.S. Centers for Disease Control and Prevention (CDC) which documented an increase in the number of suicides in children and young adults ages eight to twenty-four during 2003 — the year following the placement of a warning on the use of antidepressants by adolescents. The increase in suicides amounted to 8 percent, from 4,599 or 6.78 per 100,000 in 2003 to 7.32 deaths per 100,000 in 2004, representing the largest rise in child and adolescent suicides in fifteen years. It's also significant that this rate had fallen consistently over the previous thirteen years when diagnoses of teenage depression and anxiety and antidepressant use by adolescents had sharply increased.

Many mental health professionals subsequently voiced their strong concern, saying that under-prescribing antidepressant medications for teenagers was the greater of these two potential dangers.

Another point frequently made in this ongoing debate concerns the urgent need for and frequent lack of careful monitoring of a child's response to antidepressant medication in the weeks and months after beginning its use. For parents facing a choice about Paxil or any other antidepressant medication for an adolescent or child, discussing the relative risks involved and staying in close contact with your doctor during treatment is a vital cautionary strategy.