Thomas Kingston's family calls for antidepressant prescription change

The parents of Thomas Kingston, the husband of Prince and Princess Michael of Kent's daughter, have warned about the side effects of antidepressants after he took his own life.

Mr Kingston, who was married to Lady Gabriella Kingston, the King's second cousin, died from a head injury in February last year at his parents' home in the Cotswolds. A gun was found near his body.

The 45-year-old had stopped taking his medication, which had been prescribed by a GP at the Royal Mews Surgery - a surgery for Royal Household staff in Buckingham Palace - in the days leading up to his death.

His parents, Martin and Jill Kingston, are now calling for a change in how patients are prescribed selective serotonin reuptake inhibitors (SSRI) - a widely used type of antidepressant.

Martin Kingston told BBC Radio 4's Today programme he believes both the patient and the people close to them should be told more explicitly about the potential side effects of the medication, including what can happen if they stop taking it.

The couple want patients to sign a document confirming they've been told about the difficulties of going on and coming off the medication. This could include the patient being told that "it's an extreme case, but it could lead to suicide", Mrs Kingston says.

"We'd really like to see that a person, a spouse, a partner, a parent, a close friend, somebody, was going to walk with them through it. Maybe they should be at that signing time."

He says part of the issue is doctors are under pressure to help patients during a typically short appointment slot. He says if a person complained that they were stressed and not sleeping and rejected the GP's suggestion to try cognitive behavioural therapy, a talking therapy used to help with mental health conditions, the doctor might prescribe an antidepressant out of a "desire to help".

More than 8.7 million people in England were prescribed antidepressants in the 12 months to March 2024, according to the NHS Business Services Authority.

The NHS says that SSRIs generally have fewer side effects than most other types of antidepressant and the majority of people will only experience "a few mild side effects", though some people "have suicidal thoughts and a desire to self-harm" when they first take them. It advises patients to tell a relative or close friend that they've started taking antidepressants and ask them to say if they're worried about changes in their behaviour.

When people come off antidepressants, the NHS advises they reduce their dose "slowly, normally over several weeks or months", to prevent withdrawal symptoms, which can include mood changes. The Royal College of Psychiatrists says anyone thinking of stopping antidepressants "talk to their doctor first... [T]hese medications should not be stopped abruptly".

Mrs Kingston told the Today programme she's aware of why people take SSRIs. "We have many friends who are on them, and we totally understand why they're on them at the same time," she says.

Tom had initially been prescribed sertraline and zopiclone, a sleeping tablet, after complaining of trouble sleeping following stress at work.

After returning to the GP and saying they were not making him feel better, he was moved from sertraline to citalopram, a similar SSRI drug.

He was off the medication at the time of his death and his parents say there was "nothing that raised any suspicions," though he did have a "strong reaction" to the first SSRI, Mrs Kingston says.

On the day of his death, "he was normal", she added. "He was fun. We were laughing about various things." The family spent the day relaxing, reading and sitting by the fire, she says.

Speaking about his grief, Mr Kingston told the BBC: "You have to make a conscious decision not to do the 'what if' or the 'if onlys'."

He describes Tom as a "joyful, giving, full of life and caring person".

"I would like him to be remembered as someone with a big smile on his face," he says.

After his death, the family was sent more than 400 cards and letters, he says, adding: "So many of them told us things that we never knew."

Recording a narrative conclusion at an inquest into his death in December, Katy Skerrett, senior coroner for Gloucestershire, said Thomas Kingston had taken his own life.

"The evidence of his wife, family and business partner all supports his lack of suicidal intent," she said at the inquest. "He was suffering adverse effects of medication he had recently been prescribed."

In a prevention of future deaths report, made in January, Ms Skerrett said action must be taken over the risk to patients prescribed SSRIs. She questioned whether there was adequate communication of the risks associated with such medication.

In a statement, the Royal College of Psychiatrists said antidepressants were "highly effective at reducing the symptoms of depression and other conditions such as anxiety and panic disorders, particularly when used in combination with talking therapies."

"These treatments reduce suicide risk and can save lives," a spokesman said.

Tom's parents told the Today programme they hoped that by speaking out they could prevent someone having to experience what they did.

"We wouldn't be able to be comfortable reading about somebody else going through what we've been through, if we had not made clear what we think could happen to save someone's life and save someone's grief," Mr Kingston said.

If you are affected by any of the issues raised, help and support is available via BBC Action Line.