A schoolgirl’s suicide wasn’t directly linked to the acne drug Roaccutane, according to coroner’s rules
A coroner has ruled out a direct link between the suicide of a 15-year-old girl and the teen who was prescribed a drug to treat her acne.
Jonathan Leach said the expert evidence about a possible link between isotretinoin and self-harm was that there was “no firm and agreed upon opinion.”
Annabel Wright was found in her bedroom in May 2019 by relatives at her home near Ripon, North Yorkshire, after being prescribed the drug six months earlier.
Mr Leach took a suicide claim after hearing the teen sent messages to friends on Snapchat saying she was in a low mood and “life isn’t worth living.”
Her parents Simon and Helen Wright accused authorities of “deliberate ignorance” about the effects of the drug Accutane, and warned other families would experience the heartache of the “toxic drug.”
The family had hoped for a ruling that Annabel would take her own life while her mind was disturbed by the medication.
Annabel Wright, 15, was found in her bedroom in May 2019 by relatives at her home near Ripon, North Yorkshire, after being prescribed the drug six months earlier
Her parents Simon and Helen Wright accused authorities of “deliberate ignorance” about the effects of the drug Roaccutane, warning other families would experience the heartache of the “toxic drug.”
After her death, police also found a photo Annabel had taken of Kermit the Frog hanging from a noose.
She also “scratched” her wrists with a razor in January 2019, shortly after hearing her laugh on the phone with her friends in her bedroom.
The teen’s parents believe their daughter’s death was related to the drug, also known as Accutane.
The Northallerton inquest had heard conflicting evidence from two expert dermatologists, Professor Anthony Chu and Dr Sarah Wakelin, about whether isotretinoin contributed to Annabel’s death.
Mr Leach, the assistant coroner for North Yorkshire, said Prof Chu’s claim that Annabel’s death was related to taking the Isotretinoin “was clearly beyond his level of expertise”.
“In general, he lacked the objectivity I look for in an expert,” he said.
“In contrast, I find Dr Wakelin to be measured and willing to nuance her opinion and evidence and say when a question was outside her area of expertise.
“For these reasons, I prefer Dr. Wakelin’s evidence in a conflict.”
Mr Leach noted his findings and said: ‘There is no evidence that the balance in Annabel’s mind was disturbed and the fact that she committed suicide does not in itself mean that the balance in her mind was disturbed, and if she was, there is no proof. that this was caused or contributed to by isotretinoin.
“The only evidence was from Annabel’s parents, who could admit no other reason why she would commit suicide, and Prof. Chu’s, and that part of his evidence was outside his area of expertise.”
The investigation found that Annabel went to her GP about her acne at age 12 and was later referred to Harrogate District Hospital when she was 14.
Her mother, Helen Wright, told the inquest that her daughter had shown no signs of depression and that her death “just made no sense.”
The family had hoped for a verdict that Annabel had committed suicide while her mind was disturbed by the medication
Ms Wright added: “I was not aware that suicidal impulses can overcome a perfectly normal person.”
Annabel’s father, Simon Wright, told the inquest: “There was no harbinger of depression, mood swings, being depressed or anything like that.
“Annabel was Annabel, so I believe it was related.”
The investigation revealed that Annabel was seen by two different dermatologists, Dr. Ibtessam El-Mansori and Dr. Alison Layton, before being prescribed Isotretinoin.
dr. Layton said she explained “all the adverse effects” of the treatment to patients and their parents, including the small risk associated with depression and suicide.
In his findings, Mr Leach said the decision to prescribe Isotretinoin was reasonable and the formal consent process was followed.
‘I am satisfied with the issue of suicide and a link with isotretinoin was raised and Dr El-Mansori advised that causation had not been established and that there are other factors that contribute to suicide if suicide occurs.
‘I am pleased that the Society of Dermatology leaflet has been given and she wanted Annabel and Mrs Wright to consider her advice and in the meantime prescribed another antibiotic.
WHAT IS ROACCUTANE AND WHAT ARE THE POSSIBLE SIDE EFFECTS?
Accutane, or isotretinoin, belongs to a group of medicines known as retinoids, which are substances related to vitamin A.
It is used to treat acne that is severe or has not gotten better with other treatments, such as oral antibiotics or skin treatments.
The drug works by reducing the production of your skin’s natural oil. It is also thought to reduce inflammation. Isotretinoin capsules are prescribed for you by a specialized skin doctor.
In general, many side effects of isotretinoin are similar to those of very high doses of vitamin A.
Gastrointestinal adverse reactions included inflammatory bowel disease, pancreatitis, bleeding and gingival inflammation, colitis, esophagitis/oesophageal ulceration, ileitis, nausea and other non-specific gastrointestinal symptoms.
Common side effects reported include:
- burning sensation, redness, itching or other signs of eye inflammation
- bone or joint pain
- difficulty moving
- scaling, redness, burning, pain or other signs of inflammation of the lips
- skin infection or rash
Reported rare side effects include:
- Abdominal or stomach pain (severe)
- suicide attempts or thoughts of suicide (usually stops after the medicine is stopped)
- bleeding or inflammation of the gums
- blurred vision or other vision changes
- behavioral changes
Sources: Drugs.com and Patient
“I do not accept that Annabel and Ms. Wright were not informed at all about the risks of taking Isotretinoin and I feel that the treatment options discussed and recommended were correct and proportionate.”
Outside the court in Northallerton, North Yorkshire, the pair stood together as Mrs Wright read a prepared statement, criticizing the coroner and NHS bosses.
She said: ‘The evidence presented during this study has shown that our normal, happy, well-adjusted child committed suicide, suddenly, without warning and without any extenuating circumstance, other than taking a drug that can cause suicide.
“Nevertheless, the coroner did not consider it appropriate to implicate this drug in her death. We are disappointed but not surprised by the verdict handed down here today.
“Annabel was let down by Harrogate Hospital when they prescribed her a drug she didn’t need, although it could cause suicide.
“She was abandoned in life and has been let down by authorities’ steadfast refusal to recognize the role that isotretinoin played in her death.
“But we – our family, friends and people who knew her – know the real truth, and this will not be changed by the opinions of those who never met her, but still had the power to judge her.
“We are where we are now because in previous cases the authorities have not listened to parents who have lost their children to this drug.
‘Whatever the conclusion of this study, it would never change anything for us.
“Annabel, our dear daughter, is dead. But by failing to produce a PFD (Prevention of Future Deaths) report detailing the role isotretinoin played in her death, the coroner missed a valuable opportunity to prevent what happened to Annabel from another child, a other family, would happen.
“We know we will never get justice for our child, but we’ve done our best to gain recognition for the role that isotretinoin played in Annabel’s death.
“In the face of willful ignorance on the part of those who refuse to listen, we couldn’t do more.
In view of this, we – as grieving parents – would like to take this opportunity to warn others of the dangers of isotretinoin, as they will not hear about the real side effects, including sudden suicidal impulses, from those who lightly prescribe it.
“We hope others will respond to this tragedy and refuse to let their children use this toxic drug.”
Mr Wright had nothing to add to the statement other than saying that he found the entire handling of the case, including the inquest, “bizarre.”
If this story has touched you, call the Samaritans at 116 123 or visit www.samaritans.org.