Six weeks before Thomas Kingston took his life on February 25 this year, he went to his GP complaining of sleep problems.
He was prescribed zopiclone, a sleeping tablet, and a few weeks later, after complaining of work stress, he was also given sertraline, a type of SSRI (a selective serotonin reuptake inhibitor) – the most commonly prescribed class of antidepressants.
But the sertraline reportedly made the 45-year-old financier more anxious and he stopped taking it, so his GP switched him to citalopram, another SSRI drug.
His wife, Lady Gabriella Windsor, told an inquest last week that her husband had 'seemed normal’ in the weeks leading up to his death. The weekend that he died he was at his parents’ home in Gloucestershire and was apparently in good spirits – his last message to his wife was 'all is good here’.
What would make a man who, according to his wife, had 'seemed normal’, climb the stairs of his family home, lock himself in a bathroom and take his life with a shotgun?
His family were in no doubt that his death was caused by what Lady Gabriella described as 'an adverse reaction to the pills’.
The coroner came to the same conclusion: '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.’
His widow also said: 'If this can happen to Tom it can happen to anyone.’
Liam James Collins with his beloved late father John who killed himself six years ago
The tragedy of this is that she is right. I hear countless similar stories from the heartbroken relatives of people who have taken their lives after suffering a reaction to antidepressants, mainly SSRIs.
They contact me through antidepressant risks.org, a not for profit website I set up with leading experts to warn people that while these drugs can benefit some, they can be lethally dangerous to others. And the lives of people such as Thomas Kingston are being needlessly lost because people haven’t been warned of the signs of an adverse reaction to the drugs.
Nearly nine million people in the UK are taking antidepressants. Listed as a 'common’ side-effect of citalopram (one of the drugs Thomas Kingston took), 'suicide attempt’ occurs in between one to ten per cent of cases, according to drugs.com, an independent medicine information website.
There is similar data for the other SSRIs. While the official view is that it’s mental health that makes those taking the drugs suicidal, some experts believe that the drugs themselves are to blame.
The family of 60-year-old John Collins, who killed himself six years ago, believe his medication was behind his death – and his GP agrees with them.
His son, Liam, is co-founder of The Coaching Masters, a successful global online life-coaching academy. As well as being a successful entrepreneur, the 35-year-old Brit is well known as an actor, appearing with Benedict Cumberbatch in the short film Little Favour and other lead roles.
I first heard about Liam and his father in 2019, quite unexpectedly, when Liam was speaking at a conference on life coaching, with an audience of more than 1,000 entrepreneurs, telling them about the hardest day of his life.
His calm self-assurance wavered with emotion as he described the events of October 29, 2018: 'That was the day I lost my best friend, my father, in a way I couldn’t explain.’ He went on to describe how he was on the phone to his mother, Denise, a hypnotherapist, when she said there was someone at the door. It was the police, who’d come to tell her that John had killed himself by stepping in front of a train.
Thomas Kingston with his wife, Lady Gabriella. Thomas took his life on February 25 this year after he went to his GP complaining of sleep problems
Lady Gabriella told an inquest last week that her husband had 'seemed normal’ in the weeks leading up to his death. Pictured on their wedding day in 2019
His mother was crying so much she couldn’t talk and so she passed the phone to the police to tell Liam. But Liam couldn’t take in what the police officer was telling him.
’Anyone who had known my dad would understand why,’ he said.
’My dad loved life more than anyone I’ve ever met. He was grateful for his home, his wife, his business [he was a self-employed plumber], his kids. If anyone ranked people likely to take their life, my dad would be right at the bottom.’
As Liam continued to tell the audience about the events that led up to his father’s suicide, I already knew what he was going to say next.
He said: 'Ten days before his death, my dad had phoned his doctor because he had trouble sleeping. Over the phone, the doctor prescribed an antidepressant and sleeping tablets. Later I discovered that for some people, antidepressants can cause them to want to kill themselves in just a few days.’
My certainty of how Liam’s story was going to unfold was because I’ve heard this kind of story countless times. I also have first-hand knowledge of how antidepressants can cause people with no history of mental illness to become suicidal, as I have previously written about in Good Health. Like John Collins, it was sleepless nights that caused me to go to my doctor in 2012.
The doctor told me an antidepressant would help and prescribed me escitalopram, an SSRI. I had such a severe adverse reaction to the drug that after just a few doses I went into a four-day toxic delirium, in which I hallucinated that I had killed my children and had an uncontrollable urge to take my own life.
I was admitted to a private hospital and forced to take more drugs. For an entire year I experienced the chemically induced despair and suicidal thoughts these drugs can cause in the estimated one to ten per cent who can’t tolerate them.
My nightmare ended when I was admitted to another hospital and was taken off all seven drugs I had been prescribed. Within three weeks, I had completely recovered.
I know how lucky I am to survive my adverse reaction: many don’t.
One sign of an adverse reaction is a drug-induced toxic effect called serotonin syndrome, which is characterised by 'temperature dysregulation’ (where your body goes from feeling very hot to feeling cold and shivery) and a clouding of consciousness (where you experience delirium and confusion).
The expert report from Thomas Kingston’s inquest said that serotonin syndrome was the most likely factor leading to him taking his life.
Another sign is akathisia, which means 'an inability to sit still’. It can occur when people go on drugs such as antidepressants, or if they change the dose or come off it altogether.
As well as a compulsion to move, sufferers experience a sense of sheer terror. The condition is so excruciating that it’s been known to drive sufferers to end their lives within hours of taking a pill.
Liam as a child with his father John, who killed himself by stepping in front of a train
Liam is co-founder of The Coaching Masters, a successful global online life-coaching academy. The 35-year-old is well known as an actor, appearing with Benedict Cumberbatch in the short film Little Favour and other lead roles
During my year on antidepressants and antipsychotics, I had akathisia. The fact that I was detained in hospital probably saved my life, because there were times when it was so intolerable I would have taken my life to end the agony.
It’s thought to be caused by an irritation of the nervous system, affecting dopamine, the neurotransmitter (chemical messenger in the brain) involved in controlling movement.
’Antidepressants mostly affect neurotransmitters such as serotonin, but this can in turn affect dopamine,’ says Dr Mark Horowitz, a clinical research fellow in psychiatry at North East London NHS Trust.
Dr Horowitz has personal experience of akathisia after he came off an antidepressant. 'It was so bad I ran until my feet bled to get some relief from it,’ he says.
It is clear that Liam’s father suffered from this excruciating condition – although like so many people, his family were unaware of the dangers.
I met Liam recently in his immaculate penthouse flat in south London, where he lives with his wife Claudia, 31, a relationship coach, and their children, Posey, four, and Axton, six months.
With its large roof terrace overlooking the city, it reflects his success. Liam grew up in a working-class family in south-east London, and as he speaks about his father, he says life growing up 'was tough – there were five of us in a small terrace council house and we were poor.
’My parents did an amazing job at hiding that fact and did everything they could to provide. It was a warm place but with many struggles.’ John 'was a glass half full person’ Liam says. 'He dealt with everything with immense humour. He was always cracking jokes and was just hilarious.’
Liam is adamant his father never experienced depression. 'He was one of the most mentally resilient people I know; he was never anxious,’ he says.
In October 2018, two weeks before John took his life, Liam recalls the moment that began the downward spiral that ended with his suicide.
He says: 'I was at Mum and Dad’s house for dinner when the phone rang. My dad took it and I could hear his twin brother, Jim, saying: 'Are you sitting down?’ ’
Jim had been told he had only a few months to live.
’Jim had a cancerous lump on his throat for years, so although the news was shocking, it wasn’t unexpected,’ says Liam.
’Of course, my dad was upset, but his first reaction was he wanted Jim to have as good a time as possible before he died.
Liam with his wife Claudia, 31, a relationship coach. Liam says his father was 'one of the most mentally resilient people I know; he was never anxious’
He wanted to take him to Egypt to see the pyramids because that was his lifelong dream. He was focused and energetic, booking flights and making plans.
’He came to stay with us in London so we could take Jim out to dinner and we had a great time.’
The next day, without his family knowing, John asked his doctor for sleeping tablets and was given the antidepressant citalopram, as well as zopiclone. The same drugs taken by Thomas Kingston.
A few days later, Liam, Claudia and Jim went to stay at his parents’ house in Essex for the weekend.
Liam recalls: 'As soon as we arrived I noticed Dad was totally different. We were all sitting in the living room but he wouldn’t join us, he wouldn’t sit down. He was fidgety and pacing up and down; he couldn’t hold a conversation.’
Liam is describing akathisia. He continues: 'Usually he’d be cracking jokes and laughing his head off. But it seemed painful for him to sit still and he kept on getting up to walk around. That was the last time I saw Dad.’
A week later John took his life.
’The CCTV footage [from the train station] shows him walking up and down the platform looking confused, as if in a psychotic haze,’ says Liam.
As the family tried to piece together anything that could give them clues as to why John took his life, Denise rang the GP.
She discovered her husband had been given citalopram ten days before his suicide. 'He’d told the doctor that he was having trouble sleeping because his brother was ill,’ says Liam. 'He didn’t go there for an antidepressant.
’My dad was a typical working-class man and would have thought, 'If the doctor has told me to take an antidepressant then I need to do what he says’.
’Mum did a bit of research and discovered that these pills can make you suicidal. We Googled 'side-effects of antidepressants’ and we found akathisia.’
Liam and his mother went to see the GP, who was 'apologetic’ and admitted it was a rare side-effect of the drugs. 'He said that prescribing my dad an antidepressant was the worst decision of his life,’ recalls Liam.
’The tragedy is that my dad wasn’t depressed, he just couldn’t sleep. He had just bought an espresso machine and was drinking five of them before bed – that’s why he couldn’t sleep.
’As a life coach, I ask clients questions about their lifestyle. If the doctor had done the same, that simple question could have saved Dad’s life.’ While he believes his father should never have been prescribed an antidepressant in the first place, lives could be saved if patients taking them are properly informed, say experts.
Dr Horowitz says: 'GPs need to warn patients more explicitly about the risks of akathisia and suicidality on starting, stopping or changing the dose of an antidepressant and also switching from one medication to another.’
He adds: 'Part of the reason GPs are not able to give enough information is because current warnings given by the drug regulator, the MHRA, on suicidality and antidepressants are wholly inadequate. They give the impression it is the patient’s condition that causes suicide on starting a drug, not a reaction to the drug itself.’
Liam channeled his grief into expanding his coaching business. Four months after his father died, he met fellow coach and entrepreneur Lewis Raymond Taylor, and they formed the Coaching Masters, an online business, that has since trained over 10,000 coaches from 85 countries.
’Something positive had to come out of that experience,’ says Liam. 'My dad passed away before I had children. I know I’m a great dad because I learned from the best. But his loss could so easily have been prevented.’
Dr Alison Cave, Chief Safety Officer at the MHRA told Good Health: 'As with all medicines, SSRIs have the potential to cause side-effects which are described in the product information leaflets supplied with the medicine.
’Following concerns raised by patients and families about how the risk of suicidal behaviours is communicated in the patient leaflets, we have established a new independent expert group to advise The Commission on Human Medicines, which provides expert advice to government ministers.
’We always remind patients not to stop taking any medication without talking to their healthcare professional first.’
For information and support on akathisia, visit missd.co and akathisiaalliance.org
