Coroner in call for clearer guidance on antidepressants after suicide of Thomas Kingston - friend of Princes Harry and William

A coroner has called for guidance issued with anti-depressants to be reviewed in the wake of the suicide of a childhood friend of Prince William and Prince Harry who was prescribed the medication by a Buckingham Palace GP.

An inquest which concluded last month ruled that Thomas Kingston, 45, the husband of Lady Gabriella Windsor, took his own life by shooting himself in the head after suffering an ‘adverse effect’ to SSRI medication.

Now, Katy Skerret, HM Senior Coroner for Gloucestershire, is calling on the medical authorities to carry out an urgent review into the suicide risks around prescription selective serotonin reuptake inhibitor medication and the associated guidance.

In a Prevention of Future Deaths report sent on Thursday<(9 Jan>to the National Institute for Health and Care Excellence (NICE), the Medicines and Healthcare Products Regulatory Agency and the Royal College of General Practitioners, she asked the bodies to review 'whether there is adequate communication of the risks of suicide associated with the SSRI medications", and, if 'the current guidance to persist with SSRI medication or switch to an alternative SSRI medication is appropriate when no benefit has been achieved and/or especially when any adverse side effects are being experienced.'

Mr Kingston was a childhood friend of both princes and was later seen at royal events with Pippa Middleton in the early 2010s.

He was a director at London finance firm Devonport Capital after working in hostage negotiation and conflict resolution in Iraq.

He died from a shotgun wound to the head at the home of his parents in the Cotswolds in February 2024 after locking himself in the bathroom.

Her report added: 'The deceased was a 45 year old man who was visiting his parents in Kemble, Gloucestershire, for the weekend. He had recently been experiencing anxiety, but had not expressed any suicidal ideation.

'On Sunday 25th February 2024 after lunch he began to unload his car, and prepared to return to London. Between approximately 5pm to 6pm he removed a shotgun from his vehicle which he had recently borrowed from his father for a shoot.

'He then accessed an annex attached to his parent’s property. Within a locked bathroom he self inflicted a gunshot to the head, and sustained injuries incompatible with life.

'He was subsequently found by his father. He was pronounced deceased at 6:54pm by attending police, who confirmed there were no suspicious circumstances surrounding his death.'

The medical cause of death was 1A Traumatic wound to head.

The inquest was told Mr Kingston was initially given SSRI sertraline and zopiclone, a sleeping tablet, by a GP at the Royal Mews Surgery, a practice at Buckingham Palace, after complaining of trouble sleeping through work-related stress.

But, he returned to the surgery saying the drugs were not helping, and the SSRI was changed to similar drug citalopram.

The inquest was told that he stopped taking this drug in the days leading up to his death.

Lady Gabriella told the inquest: '(Work) was certainly a challenge for him over the years but I highly doubt it would have led him to take his own life, and it seemed much improved.

'The fact that he took his life at the home of his beloved parents suggests the decision was the result of a sudden impulse.

'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.'

Recording a narrative conclusion, Ms Skerrett said that Mr Kingston had taken his own life, adding: "The evidence of his wife, family and business partner all supports his lack of suicidal intent.

'He was suffering adverse effects of medication he had recently been prescribed."

She added in her report: "In my opinion there is a risk that future deaths will occur unless action is taken."

The three bodies, which have been contacted for comment, have 56 days to respond.

Her report comes after MPs pushed for an ‘urgent reduction’ of how antidepressants are prescribed, after the inquest.

Labour MP, and practicing GP, Dr Simon Opher said doctors must stop prescribing them in such large numbers, and that more support is needed when people start or come off them, when suicide risk is highest.

The MP chairs the ‘Beyond Pills’ All-Party Parliamentary Group, which is calling for an urgent reduction in antidepressant prescribing.

He added: "While antidepressants may be helpful for some patients, at least in the short term, non-drug options are often a better choice for the large cohort who present with mild to moderate depression.

‘Also, we need to explain to patients the risk of possible adverse effects, including those experienced by Thomas Kingston, and offer existing patients services to help withdraw safely where appropriate, alongside psychosocial support."

A 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.”