Robert Stevenson, a 63-year-old retired cardiologist, died by suicide in May 2022 just days after being prescribed a new medication, ciprofloxacin.
A coroner reviewing the case has now shared his full report, noting that ciprofloxacin is linked to rare side effects, including suicidal behavior, but this may have not been discussed at any point when the medication was being prescribed.
“I heard evidence to suggest that the prescribing doctor did not reference this side effect at the time of issuing the prescription to Mr. Stevenson, since it was not in accord with current advice,” according to coroner Martin Fleming’s report to the Medicines and Healthcare Products Regulatory Agency (MHRA). “I also heard evidence to suggest that prescribing doctors may not be fully aware of this rare side effect, and that patient’s suffering from depression may be more vulnerable to it. I am therefore concerned that this potential risk has not been given sufficient emphasis and I would ask you to consider the appropriateness of reviewing the current guidelines as to the dispensation of the drug to patients by clinicians and increasing the awareness of the side effect in order to monitor and mitigate the risks.”
Stevenson had just retired from Huddersfield Royal Infirmary in the U.K. when he was referred to a urologist for suspected prostate cancer. He was prescribed ciprofloxacin to treat his symptoms. Less than two weeks later, he was found dead by suicide, leaving a note that was “found to be uncharacteristically confused and illogical.”
“He had no previous history of depression or mental health problems,” the coroner wrote.
The report was finalized on June 7, 2023. The MHRA now has until August 1 to reply. Read the full report here.
Rare side effects of ciprofloxacin
Like all medications, ciprofloxacin is associated with a risk of many side effects. According to detailed information on the U.S. Food and Drug Administration (FDA) website, ciprofloxacin has been linked to an increased risk of certain central nervous system events, including “dizziness, confusion, tremors, hallucinations, depression, and, rarely, suicidal thoughts or acts.”
“These reactions may occur following the first dose,” the agency wrote. “If these reactions occur in patients receiving ciprofloxacin, the drug should be discontinued and appropriate measures instituted.”
Read more from the FDA here. Similar information is also listed on MedlinePlus, a website operated by the National Library of Medicine.
Help is available
The 988 Suicide and Crisis Lifeline is a network of U.S. crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week. Call 988 to speak to someone.
Information for anyone in the U.K. is available here.
Michael has more than 16 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.