Antidepressants Sertraline and Citalopram taken by Thomas Kingston before suicide flagged 40 times by coroners

The antidepressants taken by Thomas Kingston before he killed himself have ben flagged more than 40 times by coroners, it has been found.

The 45-year-old husband of Lady Gabriella Windsor took his own life in February last year at his parents’ home in the Cotswolds.

The financier had been prescribed sertraline, citalopram – both selective serotonin reuptake inhibitors (SSRIs) – and zopiclone, a sleeping tablet, before his death.

Following an inquest into his death, senior coroner for Gloucestershire Katy Skerrett concluded that the financier was “suffering adverse effects” of medication he had recently been prescribed.

In a prevention of future deaths report (PFD), she questioned whether there is adequate communication of the risks of suicide associated with such medication.

Ms Skerrett is the latest in a string of coroners to have referenced either citalopram or sertraline in reports. Analysis by The Times found that at least 40 PFD reports mentioned the use of the SSRIs by the deceased person.

One report, issued by Michael Spencer, assistant coroner for East Sussex in May 2023, found that Joshua Asprey, 19, took his own life 18 days after he began taking sertraline in 2021.

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Mr Spencer found that Mr Asprey’s GP “did not discuss any risk of suicidal ideation associated with commencing or increasing the dose of sertraline” and highlighted that the medicines guidebook “does not identify suicidal ideation as a risk of prescribing sertraline”.

Similar cases were reported by coroners in the years prior to Mr Asprey’s death. In 2016 a Cambridgeshire coroner expressed concern that 18-year-old Edward Mallen had taken his own life two weeks after being prescribed citalopram.

Emma Bray, 25, took her own life 17 days after her sertraline dosage had been increased, with Laura Johnson, an assistant coroner for east London, stating in a PFD report: “Risks associated with the drug sertraline do not appear to have been communicated to Emma and her family.”

In 2020, a coroner advised citalopram should come with a warning after Samuel Morgan, 25, took his own life seven days after he began to take the drug.

Swansea coroner Colin Phillips wrote: “Whilst the precise effect of this medication (Citalopram) on Sam is unknown, it is clear that Sam had never self-harmed previously and his actions were completely out of character.”

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He suggested the drug should come with a “Black Box Warning” to facilitate a “more immediate impact and capture some patient’s attention highlighting any risks”.

“The simple and clear message in this specific case would be that there is an increased risk of suicidal thinking in young adults. The benefits of such simple and direct messaging extends to all prescribed medicines and associated major risks,” the report read.

Giving evidence to Mr Kingston’s inquest last year, Dr David Healy, a psychiatric medical expert, said Mr Kingston’s complaints that sertraline was continuing to make him anxious was a sign SSRIs “did not suit him” and he should not have been prescribed the same thing again.

He said the guidelines and labels for SSRIs were not clear enough about going on the drugs in the first place or what the effect could be when 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.

A National Institute for Health and Care Excellence (Nice) spokesperson said: “Nice can confirm we have received the coroner’s prevention of future deaths report in relation to Thomas Kingston. We will consider the issues raised by the report and respond to the coroner directly.

“We follow an established process when making sure our published guidelines are current and accurate and take a proactive approach to responding to events (with an assessment of priority) that may impact on our recommendations.”