Coroner issues warning over depression medications following Thomas Kingston’s death

A coroner has issued a warning about the effects of drugs used to treat depression after the husband of the Duke and Duchess of Kent’s daughter Michael of Kent took his own life.

Thomas Kingston, a 45-year-old financier, died from a head injury and a gun was found next to his body at his parents’ home in the Cotswolds on February 25 last year.

The coroner found that Kingston took his own life and “experienced side effects from medications he had recently been prescribed.”

He married Lady Gabriella, 43, at Windsor Castle in 2019, with guests including Queen Elizabeth II and the late Duke of Edinburgh.

Last year’s inquest into his death at Gloucestershire Coroner’s Court heard that he was initially given sertraline, a drug used to treat mental health problems, and zopiclone, a sleeping pill, from a GP at the Royal Mews Surgery, a practice at Buckingham Palace. used by royal household staff after complaining about sleep problems caused by work stress.

Kingston returned for surgery, finding that the medications did not make him feel better, so the doctor prescribed him sertraline with the similar drug citalopram.

A few days before his death, Kingston stopped taking his medications, and toxicology tests showed he had caffeine and small amounts of zopiclone in his system.

Katy Skerrett, senior coroner for Gloucestershire, said action needed to be taken over the risk of suicide in patients prescribed the drugs.

In a report on preventing future deaths, the coroner questioned whether the suicide risk of using such drugs was adequately communicated.

She also expressed concerns about whether current guidance on continuing selective serotonin reuptake inhibitor (SSRI) medications or switching to an alternative SSRI is appropriate when no benefit has been achieved, “particularly if any adverse side effects occur.”

The report has been sent to the National Institute for Health and Care Excellence, the Medicines and Healthcare products Regulatory Agency and the Royal College of General Practitioners, who have 56 days to respond.

The coroner’s concerns echo those of Kingston’s wife, Lady Gabriella, who warned about the effects of drugs during the inquest.

In a statement read by Ms Skerrett, she said: “(Work) has certainly been a challenge for him over the years but I very much doubt it would have led to him taking his own life and the situation seemed to have improved significantly.

“If something was bothering him, I’m sure he would say he was struggling with serious problems.

“The fact that he took his own life in the home of his beloved parents suggests that this decision was the result of a sudden impulse.”

She stated that she believed his death was “probably caused” by an adverse reaction to medications he had started and then stopped in the weeks before his death.

“In the absence of any evidence of predisposition, it seems to me highly likely that he had an adverse reaction to the pills which led him to take his life,” Lady Gabriella said.

“I believe that anyone taking such pills should be more aware of their side effects to prevent future deaths.

“If it could happen to Tom, it could happen to anyone.”

Recording her narrative conclusions, Ms Skerrett said: “Mr Kingston took his own life using a shotgun which caused a serious, traumatic head wound.

“Statements from his wife, family and business partner confirm his lack of suicidal intent.

“He was suffering from adverse effects from medications that had recently been prescribed.”

Giving evidence at the inquest, Dr David Healy, a psychiatric expert, said zopiclone can also cause anxiety, while sertraline and citalopram are SSRIs and are essentially the same thing.

Dr Healy said Mr Kingston’s complaints that sertraline continued to cause him anxiety meant SSRIs “were not suitable for him” and he should not be prescribed the same drug again.

He said guidelines and labels on SSRIs were not clear enough, particularly about how to take these drugs or what the effects of switching from one drug to another might be.

“We need a much clearer statement that these drugs can cause suicide in people who would not otherwise commit suicide,” he said.