West Yorkshire coroner warns of suicide risk link to antibiotic

The risk of suicidal behaviour as a side-effect of a certain antibiotic should be made clear to those prescribing it, a coroner has warned.

The West Yorkshire coroner’s warning comes after Dr Robert Stevenson, 63, from Huddersfield, took his own life after being prescribed ciprofloxacin.

An inquest had heard the drug could have a rare link to suicide that many medics might not be aware of.

The medicines regulator said it would decide whether more action was needed.

Dr Stevenson had retired as a Huddersfield Royal Infirmary doctor in May 2022 when he was referred for the investigation of suspected prostate cancer, a Prevention of Future Deaths report issued by the senior coroner for West Yorkshire Martin Fleming said.

He was prescribed the antibiotic ciprofloxacin for relief of his symptoms and had no previous history of depression or mental health problems, according to the report.

However, 11 days later he left home for his usual walk and was later found dead.

He had left a note under his pillow for his wife, which the coroner said contained “uncharacteristically confused and illogical” worries.

The inquest into Dr Stevenson’s death heard he had not been warned about a “potential rare link to suicide behaviour” for patients taking what are known as quinolone antibiotics.

It was not current advice to tell people about this side-effect, the inquest was told.

In his report following the inquest, the coroner said he could not be certain that Dr Stevenson was suffering from this side-effect, but that it was a possibility.

He added: “I also heard evidence to suggest that prescribing doctors may not be fully aware of this rare side-effect and that patients suffering from depression may be more vulnerable to it.”

Writing to the Medicines and Healthcare products Regulatory Agency (MHRA), Mr Fleming said he was “concerned that this potential risk has not been given sufficient emphasis”.

He urged the regulatory body to review its current guidelines for ciprofloxacin.

Responding, Dr Janine Jolly, the MHRA’s deputy director of benefit/risk evaluation, said the organisation would “consider whether further regulatory action is required to minimise risks to patients and will provide a response upon completion of our investigation”.

“Psychiatric side-effects, including suicidal behaviours, have been reported following ciprofloxacin and the patient information leaflet warns of these risks,” she said.

“As with any serious suspected side-effects, reports of fatalities are evaluated by us including an assessment of post-mortem details if available. We will be reviewing the coroner’s verdict.”

Dr David Birkenhead, medical director at Calderdale and Huddersfield NHS Foundation Trust, described Dr Stevenson as a “well-respected, valued and much-loved colleague who contributed significantly to the trust and was dedicated to the care of his patients”.

“We were all deeply saddened by his passing. Following the publication of the coroner’s report, my thoughts are first and foremost with Dr Stevenson’s family,” he added.