The suicide rate was about 4.5 per 100,000 in 2005, the most recent data available. That follows an 18 percent spike the previous year that alarmed experts when first reported.
That's because until then, suicides among 10- to 19-year-olds had been on a steady decline since 1996.
Dr. David Fassler, a psychiatry professor at the University of Vermont, said the report suggests a "very disturbing" upward trend that correlates with a decline in teen use of antidepressants.
That decline stems from the Food and Drug Administration's 2004 black-box warning label because of reports that the drugs can increase risks for suicidal tendencies.
Fassler, who wasn't involved in the new study, is among psychiatrists who believe the drugs' benefits, including treating depression that can lead to suicide, outweigh their risks. He said he has no financial ties to makers of antidepressants.
The new report shows the rate dropped by about 5 percent from 4.7 in 2004 - or from 1,983 suicides in 2004 to 1,883 in 2005.
That's still 600 more suicides than would have been expected had the earlier trend continued, said lead author Jeffrey Bridge, a researcher at Nationwide Children's Hospital in Columbus, Ohio.
Patrick Tolan, director of the University of Illinois-Chicago's juvenile research institute, said it will be important to continue tracking teen suicides to see if the rate continues to decline or hovers at a higher than expected level.
Regardless, suicide remains a leading cause of teen deaths and "a major public health issue," he said.