A coroner has issued a stark warning about the potential dangers of medication used to treat depression, following the tragic death of Thomas Kingston, the husband of Lady Gabriella, daughter of Prince and Princess Michael of Kent. Mr Kingston, a 45-year-old financier, tragically took his own life on February 25 last year at his parents’ home in the Cotswolds. A gun was discovered near his body, and a head injury was determined to be the cause of death.
The inquest into his death, which took place at Gloucestershire Coroner’s Court, concluded that Mr Kingston died by suicide, and that he was “suffering adverse effects of medication he had recently been prescribed.” The coroner, Katy Skerrett, raised significant concerns about the risks associated with certain antidepressant medications, particularly in relation to the potential for suicidal thoughts and actions.
Medication and mental health struggles
Mr Kingston had been prescribed sertraline, an antidepressant commonly used to treat mental health issues, alongside zopiclone, a sleeping tablet, after experiencing sleep difficulties following work-related stress. These medications were prescribed to him by a GP at the Royal Mews Surgery, a medical practice used by royal household staff. However, after returning to the surgery and reporting that the medication was not helping, his doctor switched him from sertraline to citalopram, another selective serotonin reuptake inhibitor (SSRI).
The inquest revealed that in the days leading up to his death, Mr Kingston had stopped taking his medication entirely. Toxicology reports indicated the presence of caffeine and small amounts of zopiclone in his system, but there was no sign of the antidepressants. These findings, coupled with his wife’s testimony, led the coroner to suggest that Mr Kingston’s death may have been the result of a sudden and impulsive decision, potentially triggered by the adverse effects of the medication he had been prescribed.
Lady Gabriella’s statement
Lady Gabriella, who married Mr Kingston in 2019, provided a heartfelt statement during the inquest. She explained that, while Mr Kingston had faced challenges at work, he had seemed to improve in recent years. She expressed doubts that work stress had contributed to his death, stating, “If anything had been troubling him, I’m positive that he would have shared that he was struggling severely.” She added that the fact he took his life at his parents’ home suggested the decision was made impulsively, possibly caused by a reaction to the medication he had been taking.
Lady Gabriella further stated that she believed her husband’s death was “likely provoked” by an adverse reaction to the antidepressants, and that more awareness should be raised about the side effects of such medication to prevent similar tragedies in the future. “If this could happen to Tom, this could happen to anyone,” she warned.
The coroner’s concerns
In her prevention of future deaths report, Coroner Skerrett raised serious concerns about the guidance provided to patients prescribed SSRIs, particularly in cases where the medication is not providing a benefit or is causing adverse side effects. She questioned whether the current advice to continue with SSRIs or switch to a different one was appropriate when no improvement was observed. She also highlighted the lack of communication regarding the potential risk of suicide associated with these drugs, urging that steps be taken to ensure patients are fully informed of the possible risks.
The report has been sent to key health authorities, including the National Institute for Health and Care Excellence (NICE), the Medicines and Healthcare Products Regulatory Agency (MHRA), and the Royal College of General Practitioners. These bodies have been given 56 days to respond to the coroner’s findings.
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Expert testimony
Dr David Healy, a psychiatric medical expert who provided evidence during the inquest, explained that zopiclone, along with SSRIs such as sertraline and citalopram, can cause anxiety in some patients. He further explained that Mr Kingston’s complaints about anxiety while taking sertraline were a clear sign that SSRIs did not suit him. Dr Healy criticised the lack of clarity in the guidelines regarding the prescription of SSRIs and their potential side effects, particularly in cases where patients are switched from one SSRI to another.
“We need a much more explicit statement saying that these drugs can cause people to commit suicide who wouldn’t have otherwise,” Dr Healy stated, underscoring the need for more stringent warnings and better-informed decision-making in prescribing these medications.
NICE response
In response to the coroner’s report, a spokesperson for the National Institute for Health and Care Excellence (NICE) confirmed that they had received the document and would carefully consider the issues raised. They stated, “We follow an established process when making sure our published guidelines are current and accurate and take a proactive approach to responding to events that may impact on our recommendations.”
Conclusion
Thomas Kingston’s tragic death has brought to light important questions about the safety of antidepressant medications and the potential risks they pose to vulnerable patients. The coroner’s warning, along with expert testimony and the heartfelt statement from Lady Gabriella, calls for a review of current practices and guidelines surrounding the prescription of antidepressants, to ensure that the risks of suicide and other adverse effects are communicated clearly to patients and healthcare professionals alike.
