Lady Gabriella Kingston’s husband took his own life after suffering an adverse reaction to an antidepressant medication prescribed by his doctor, a coroner has ruled.
Thomas Kingston, who married Prince and Princess Michael of Kent’s daughter at Windsor Castle in 2019, died from a head injury and a gun was found near his body on 25 February at his parents’ home in the Cotswolds.
At an inquest into his death held at Gloucestershire Coroner’s Court on Tuesday, Lady Gabriella, 43, called for people to be warned about the effects of medications used to treat mental health conditions or she feared more people could die.
The inquest was told the 45-year-old financier had initially been given sertraline, a drug used to treat depression, and zopiclone, a sleeping tablet, by a GP at the Royal Mews Surgery, a practice at Buckingham Palace used by royal household staff, after complaining of trouble sleeping following stress at work.
Mr Kingston returned to the surgery saying they were not making him feel better, and his doctor moved him from sertraline to citalopram, a similar drug.
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.
In a statement read out by Katy Skerrett, senior coroner for Gloucestershire, Lady Gabriella, 43, 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.
“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.
“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,” Lady Gabriella said.
“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.”
In his final weeks, Lady Gabriella said, her husband had “seemed normal”, 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”.
Lady Gabriella, whose wedding to Mr Kingston included Queen Elizabeth II and the late Duke of Edinburgh among the guests, cried while she sat in the coroner’s court as her statement was read out.
Recording a narrative conclusion, 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.”
She said she intended to draft a prevention of future deaths report, which would be sent to medical bodies.
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.
He told the coroner that leading up to his son’s death there did not appear to have been any searches for suicide, and no will or note was left, describing the method as “very ragged” which was simply “out of character”.
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 (his GP) Doctor Naunton Morgan, she was acting as good doctors do.
“But the question is whether there is sufficient advice to doctors on SSRIs.”