Warning over the cocktail of prescribed drugs taken by Thomas Kingston

Doctors have warned about the potential dangers of anti-depressants after an inquest ruled Prince and Princess Michael of Kent's son-in-law took his own life after suffering an 'adverse effect' to his medication.

Lady Gabriella Windsor's husband Thomas Kingston, 45, died from a shotgun wound to the head at the home of his parents in the Cotswolds on February 25 this year.  

Prof Joanna Moncrieff, professor of critical and social psychiatry at University College London, has today raised concerns about the potentially harmful effects of taking anti-depressants – and warned people to take care when coming off them.

She told MailOnline in response to yesterday's inquest verdict: ‘It’s been recorded that some people can have a reaction to SSRIs and other anti-depressants – they can become quite agitated and more likely to have suicidal ideas.

'And people have been known to experience quite severe withdrawal effects.

'Those who have started on these drugs ought to be warned about the possible impact - there should be a good discussion with doctors about whether they are worthwhile.

'The consequences can be uncertain - the benefits of anti-depressants are uncertain.

'But people certainly shouldn’t come off them suddenly – if patients do want to come off them, they should do so in a safe manner overseen by doctors.'

The financier Mr Kingston had married Lady Gabriella at St George's Chapel, Windsor Castle, in 2019 with the late Queen Elizabeth II and her husband the Duke of Edinburgh among the guests.

Lady Gabriella, 43, spoke out at Gloucestershire Coroner's Court about how people should be warned about the effects of medications used to treat mental health conditions or else more people could die.

And witnesses expressed worries over whether doctors were being given 'sufficient advice' on handing out anti-depressants known as SSRIs (selective serotonin reuptake inhibitors).

Lady Gabriella's husband had initially been given sertraline, an anti-depressant, and sleeping tablet zopiclone, by a GP at the Royal Mews Surgery - a practice used by royal household staff - after complaining of trouble sleeping following stress at work.

Mr Kingston’s GP Dr Nicky Naunton Morgan – who also holds the title of Apothecary to the Royal Household at Buckingham Palace – said he had been taking duloxetine for nerve pain as a result of an unsuccessful foot operation in 2012, which had left him sometimes unable to walk.

In early January he was prescribed zopiclone after struggling to sleep and the following month he was prescribed sertraline, an anti-anxiety medication, after complaining of work stress - but stopped taking it after saying it made him more anxious.

His zopiclone was switched to diazepam, often sold under the brand name Valium, and sertraline was substituted with the powerful citalopram.

In a statement read out at the inquest by senior coroner Katy Skerrett, Lady Gabriella said: '(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.

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'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.'

She said she believed his death was 'likely provoked' by an adverse reaction to the medication he had begun, and subsequently stopped taking, in the weeks leading up to his death.

Lady Gabriella said: '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.

'I believe anyone taking pills such as these need to be made more aware of the side effects to prevent any future deaths. If this could happen to Tom, this could happen to anyone.'  

Dr David Healy, a psychiatric medical expert who gave evidence to the hearing, said zopiclone could also cause anxiety, while sertraline and citalopram were both selective serotonin reuptake inhibitors (SSRIs), and essentially the same.

Dr Healy 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.

Addressing the coroner, Martin Porter, counsel for the family, said: 'The family don't blame Dr Naunton Morgan - she was acting as good doctors do. But the question is whether there is sufficient advice to doctors on 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. 

Lady Gabriella said her husband had 'seemed normal' in his final weeks, apart from early in the day after previously taking zopiclone, which she said made him seem 'almost hungover'.

In her statement, she described their marriage as 'deeply loving and trusting' and said he had never expressed any suicidal thoughts to her or others.

She added that he had been deeply affected by the suicide of a friend and the 'devastating impact it had on other people's loved ones'. 

Mr Kingston's father William Martin Kingston broke down in tears as he described finding his son in the locked bathroom of a detached annexe, having used a crowbar to break down the door.

He told the court his son had always had a strong, resilient character, having previously suffered from a pain condition which left him needing help to get up the stairs.

Mr Kingston added that leading up to his son's death there did not appear to have been any searches for suicide, with no will nor note left, describing the method as 'very ragged' and which was simply 'out of character'.

Recording a narrative conclusion, Gloucestershire senior coroner Ms Skerrett said: 'Mr Kingston took his own life using a shotgun which caused a severe traumatic wound to the head.

'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.'

Lady Gabriella paid tribute to her husband in a joint statement with his family after his death, describing Mr Kingston as an 'exceptional man who lit up the lives of all who knew him'.

The King and Queen also sent their 'most heartfelt thoughts and prayers' to Lady Gabriella, who is known as Ella, and Mr Kingston's parents and siblings.

About 140 close friends and family, including Prince William, Lady Gabriella's parents Prince and Princess Michael of Kent, and Princess Alexandra, gathered at the Chapel Royal in St James's Palace in London for Mr Kingston's funeral on March 12.

Lady Gabriella is the King's second cousin and they are both great-grandchildren of King George V.

Mr Kingston was a director of Devonport Capital, which specialises in providing finance for companies in 'frontier economies'.

The Bristol University graduate had also worked in Iraq's capital Baghdad to procure the release of hostages after joining the diplomatic missions unit of the Foreign Office.

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