The parents of Thomas Kingston, the husband of Prince and Princess Michael of Kent’s daughter, have warned about the side-effects of antidepressants after he took his own life.
Mr Kingston, who was married to Lady Gabriella Kingston, died from a head injury and a gun was found near his body in February last year at his parents’ home in the Cotswolds.
A coroner concluded in January that Mr Kingston took his own life and was “suffering adverse effects of medication he had recently been prescribed”.
The inquest into his death at Gloucestershire Coroner’s Court was told he had initially been given sertraline, a drug used to treat depression and mental health problems, and zopiclone, a sleeping tablet, by a GP at the Royal Mews Surgery, a practice at Buckingham Palace used by royal household staff, after complaining of trouble sleeping following stress at work.
Mr Kingston returned to the surgery saying they were not making him feel better and his doctor moved him from sertraline to citalopram. Both of these drugs are selective serotonin reuptake inhibitors (SSRIs).
In the days leading up to his death, Mr Kingston had stopped taking medication and toxicology tests showed caffeine and small amounts of zopiclone in his system.
His parents, Martin and Jill Kingston, are now calling for a change in how patients are prescribed SSRIs.
Martin Kingston told BBC Radio 4’s Today programme he believes both the patient and the people close to them should be told more explicitly about the potential side effects of the medication, including what can happen if they stop taking it.
The couple wants patients to sign a document confirming they have been told about the difficulties of going on and coming off the medication.
This could include the patient being told that “it’s an extreme case, but it could lead to suicide”, Mrs Kingston said.
“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 be at that signing time.”
Mr Kingston said if a person complained they were stressed and not sleeping and rejected the GP’s suggestion to try cognitive behavioural therapy, a talking therapy used to help with mental health conditions, the doctor might prescribe an antidepressant out of a “desire to help”.
According to the NHS website, the common side effects of sertraline – such as nausea or tiredness – tend to gradually improve as the body gets used to it.
People are told to call 999 or go to A&E immediately if they have thoughts about harming themselves “or ending your life”.
When people come off antidepressants, they should reduce their dose slowly over several weeks or months with the help of a doctor, to prevent withdrawal symptoms, which can include mood changes.
Mrs Kingston told the Today programme she was aware of why people take SSRIs.
“We have many friends who are on them, and we totally understand why they’re on them at the same time,” she said.
On the day of his death, Mr Kingston “was normal”, his mother said.
“He was fun. We were laughing about various things.”
The family spent the day relaxing, reading and sitting by the fire, she added.
Speaking about his grief, Mr Kingston told the BBC: “You have to make a conscious decision not to do the ‘what if’ or the ‘if onlys’.”
He said his son was a “joyful, giving, full of life and caring person”.
“I would like him to be remembered as someone with a big smile on his face,” he said.
After his death, the family was sent more than 400 cards and letters.
“So many of them told us things that we never knew,” Mr Kingston said.
Giving her verdict earlier this year, 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.”