The family of Thomas Kingston, the husband of the King’s second cousin, have warned about the side effects of a widely-used antidepressant after he took his own life.
Mr Kingston, who was married to Lady Gabriella Kingston, the daughter of Prince and Princess Michael of Kent, died from a head injury at his parents’ home in the Cotswolds last year, with a gun found next to his body.
The 45-year-old had been prescribed the selective serotonin reuptake inhibitors (SSRI) sertraline then citalopram by a GP at the Royal Mews Surgery, which provides services for royal household staff at Buckingham Palace, but had stopped taking the medication in the days leading up to his death.
A coroner concluded in January that he had taken his own life after “suffering adverse effects of a medication he had recently been prescribed”. He had been put on SSRIs, drugs commonly used to treat depression and other mental health issues, after having trouble sleeping due to work-related stress.
Mr Kingston’s parents Martin and Jill have called for a reassessment of how patients are prescribed the drugs, warning that they should be told more explicitly about potential side effects, including the consequences of suddenly coming off them.
They said GPs should tell those being prescribed SSRIs that in “extreme” circumstances, quitting the drugs could “lead to suicide”.
The couple told BBC Radio 4’s Today programme: “We’d really like to see that a person, a spouse, a partner, a parent, a close friend, somebody, was going to walk with them through it. Maybe they should at signing time.
“We have many friends who are on [antidepressants] and we totally understand why they’re on them at the same time,” Mrs Kingston said, adding that on the day of his death her son had been “normal and fun”.
“You have to make a conscious decision not to do the ‘what if’ or ‘if onlys’,” Mr Kingston told the BBC. “I would like him to be remembered as someone with a big smile on his face.”
NHS guidance says SSRIs are often GPs’ first port of call for depression medication “because they generally have fewer side effects than most other types of antidepressant”.
It also recommends that dosage begins on the lowest possible level and that “it’s important [not to stop] taking the medication” early-on in spite of mild effects.
While the website suggests that symptoms including nausea and headaches are likely to ease after a few weeks of taking medications including citalopram, it also urges anyone who experiences “thoughts about harming yourself or ending your life” to call 999 to go to A&E immediately.
After giving the inquest verdict, Katy Skerrett, senior coroner for Gloucestershire, said action must be taken over the risk of suicide to patients prescribed the drugs.
In a prevention of future deaths report, the coroner questioned whether there is adequate communication of the risks of suicide associated with such medication.
She also raised concerns about whether the current guidance to persist with SSRI medications, or switch to an alternative SSRI medication is appropriate when no benefit has been achieved, “especially when any adverse side effects are being experienced”.
In a statement read to the inquest, Lady Gabriella said while Mr Kingston’s work was “certainly a challenge for him over the years”, she doubted it would have led him to take his own life.
“If anything had been troubling him, I’m positive that he would have shared that he was struggling severely.
“The fact that he took his life at the home of his beloved parents suggests the decision was the result of a sudden impulse.”
Lady Gabriella added: “The lack of any evidence of inclination, it seems highly likely to me that he had an adverse reaction to the pills that led him to take his life.”
The Samaritans can be reached round the clock, 24 hours a day, 365 days a year.
If you need a response immediately, it’s best to call them on the phone. You can reach them by calling 116 123, by emailing jo@samaritans.org.uk or by visiting www.samaritans.org