More than 100 alerts over deaths linked to antidepressants taken by Thomas Kingston

More than 100 alerts were made in a decade to the UK’s medicines regulator over deaths linked to the antidepressants which Thomas Kingston was taking before he killed himself.

A coroner ruled on Tuesday that Mr Kingston, the husband of Prince and Princess Michael of Kent’s daughter Lady Gabriella Kingston, fatally shot himself after an adverse effect to the medications he had been prescribed, which included the common antidepressant citalopram.

The UK’s medicines regulator, the Medicines and Healthcare Products Regulatory Agency (MHRA) said it is undertaking a review of safety warnings for 30 antidepressants including citalopram and prozac.

Data analysis by The Independent has now found the MHRA has received more than 71 alerts over fatalities linked to the antidepressant citalopram since 2014.

The data, called yellow card alerts, also shows 114 alerts over fatal adverse reactions linked to sertraline, another antidepressant taken by Mr Kingston, over the same period.

However, the data does not determine whether the drug was the direct cause of death.

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During the inquest, Lady Kingston called for better warnings for patients over side effects linked to antidepressants which can include anxiety and suicidal thoughts.

The MHRA review of the medication, commissioned by former minister Maria Caulfield, is looking at the effectiveness of safety warnings following families’ concerns over the loss of their loved ones.

But the regulator said it could not provide an update on the review as it is ongoing.

It added: “It’s important to note that the patient information leaflet provided in packs of citalopram as well as the summary of product characteristics for healthcare professionals includes information about the possibility of feeling increased anxiety at the start of treatment as well as the risk of having thoughts about suicide with the advice that patients should contact their doctor or go to hospital straight away.”

Citalopram and sertraline, which Mr Kingston had been prescribed before his death, are selective serotonin reuptake inhibitors (SSRIs). He had also been prescribed zopiclone which is a sedative drug.

The most recent data shows 5.2 million patients were prescribed SSRIs in 2021, up from 4.2 million in 2015-2016.

According to evidence given at his inquest, Mr Kingston had complained sertraline was making him anxious.

A medical expert at the inquest, Dr David Healy, suggested this was a sign SSRIs “did not suit him” and that he should not have been prescribed citalopram following this.

He said the guidelines and labels for SSRIs were not clear enough about the effects of using the drugs, or of moving from one to another.

“We need a much more explicit statement saying that these drugs can cause people to commit suicide who wouldn’t have otherwise,” he said.

If you are experiencing feelings of distress, or are struggling to cope, you can speak to the Samaritans, in confidence, on 116 123 (UK and ROI), email jo@samaritans.org, or visit the Samaritans website to find details of your nearest branch. If you are based in the USA, and you or someone you know needs mental health assistance right now, call or text 988, or visit 988lifeline.org to access online chat from the 988 Suicide and Crisis Lifeline. This is a free, confidential crisis hotline that is available to everyone 24 hours a day, seven days a week. If you are in another country, you can go to befrienders.org to find a helpline near you.

An earlier version of this story erroneously reported the number of alerts over fatalities linked to the antidepressant citalopram since 2014 was 216, and the number of fatal adverse reactions linked to sertraline was 704 over the same time period. These figures have now been corrected.