Every morning before leaving the house for work, Jim Connell stops at a small table in his foyer, lights a candle and says a prayer in memory of his son Darren.
“It’s a memorial table, with all his Gaelic football medals and a scrapbook his friends made to remember their happy times together,” says Jim, 47, from Oldcastle, County Meath, in the Republic of Ireland.
And every night before going to bed, Jim – who is married to Vera, 49, with whom he has four other children – does the same thing again. “My last thought before I go to sleep is always of Darren, and I know the same goes for Vera,” says Jim, who works in the dairy industry.
In September 2019, just weeks after turning 17, Darren took his own life.
It was so unexpected that the family could not explain why their charismatic and popular son, who hoped to study sports science at university and had no history of depression, would kill himself.
In September 2019, just weeks after turning 17, Darren took his own life.
“He was always looking forward, incredibly motivated and a huge presence in our house,” says Jim, who came home early from work and found Darren’s body in the garage one morning after the school told him he was missing. appeared.
But in the search for clues as to what led to Darren’s tragic loss, a clear suspect soon emerged. Just two weeks before his death, Darren’s GP had prescribed him a medication called doxycycline to treat acne, after he developed some spots on his face.
The antibiotic, which I had never taken before, has been around since the 1960s and has been taken by tens of millions of people around the world for everything from respiratory infections and acne to sexually transmitted infections and malaria prevention.
But while most patients tolerate the drug well, some studies show that it can cause sudden suicidal thoughts and behavior, even in those without a history of mental illness. In Darren’s case, he went from being a vibrant, optimistic, fitness-crazy teenager to being another suicide statistic in just over a fortnight.
For Jim and his family, the only explanation for this catastrophic decline is doxycycline. “Darren was the last person you would think this would happen to,” Jim says. “We’ve been racking our brains to remember if there were any signs we missed.”
But it’s not just his distraught parents who blame the drugs.
In October last year, the County Meath coroner, in his report into Darren’s death, described the evidence that doxycycline played a role in Darren’s death as “compelling” and asked the Health Products Regulatory Authority (which monitors medicines safety in the Republic) consider whether patient information leaflets on doxycycline should be revised to warn about the risk of sudden suicidality.
Now Good Health can reveal that the European Medicines Agency (EMA), which examines the safety and effectiveness of prescription drugs across the European Union, is investigating the psychiatric safety of doxycycline.
The agency announced on its website in July that it was reviewing evidence on the drug due to a “steady stream of reports” that previously mentally stable people were taking their own lives, often within days or weeks of starting to take it. the medicine.
Launching the investigation, the EMA said: “Concerns have recently been raised about the possible neuropsychiatric side effects of doxycycline, particularly in relation to suicide.”
Some studies have suggested a possible link between doxycycline and increased risks of depression and anxiety, which are known risk factors for suicidality. “Evaluating this potential association is crucial to understanding the full safety profile of doxycycline and ensuring patient safety.”
The study review, which will be completed in the coming weeks, compares suicide rates (and suicide attempts) among people taking doxycycline with patients taking other antibiotics or acne medications, such as erythromycin, azithromycin, and amoxicillin.
At Darren’s funeral, family and friends carried his coffin, draped in the colors of Oldcastle football club (his local team), to the field where he played so many times.
If the EMA determines that doxycycline carries a higher risk – as victims’ families suspect – it may require that packaging and patient information leaflets warn about the potential dangers.
Any changes are likely to influence the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), to do the same in this case. Currently, doxycycline labeling does not mention mental health risks or suicidality.
Darren’s story has worrying similarities to that of Alana Cutland, the 19-year-old Cambridge University student who fell from a small plane at 5,000 feet over Madagascar in July 2019 after taking doxycycline for 11 days to protect herself from malaria.
Alana, who was studying natural biological sciences, was on a research trip and became ill within a few days, showing signs of paranoia and becoming withdrawn. Her worried parents had organized flights home and the plane was taking her to the main airport.
At his inquest, Milton Keynes coroner Tom Osborne concluded – after consulting experts who were investigating the effects of doxycycline on psychiatric well-being – that the drug triggered a “psychotic reaction” and asked the MHRA to review the information provided to patients about the dangers of doxycycline.
In a statement to Good Health, the MHRA said it “continuously monitors” the safety of all medicines, “including the potential safety signal associated with doxycycline and the risk of suicidal thoughts.”
He added: “Any emerging evidence is routinely considered, along with other sources of information, including suspected adverse reactions.” But although the MHRA is still gathering evidence, more studies are highlighting the drug’s apparent psychotic effects – and not just in teenagers or adults.
In July, researchers at China Pharmaceutical University published a review of the safety of a class of antibiotics called tetracyclines (which includes doxycycline, often used to treat acne) for children ages eight to 18.
The researchers analyzed nearly 20 years of data from the U.S. Food and Drug Administration’s Adverse Event Reporting System, a catalog of adverse drug reactions reported by doctors and patients.
Their findings, published in the journal Frontiers in Pharmacology in July, showed that with side effects such as skin reactions or stomach upset, doxycycline was no more likely to be a trigger than two other drugs in the same class, minocycline and tigecycline. .
But with psychiatric reactions, it was a different story. Of more than 1,900 adverse reactions of all types, there were 44 cases of suicidal thoughts or suicide attempts, and 35 of them to doxycycline. Minocycline, on the other hand, was linked to eight and tigecycline to none.
The researchers said: “Our study indicates a potential increase in psychiatric risks associated with doxycycline use in children, which is currently not mentioned in the prescribing information.”
‘Specifically, they suggest a possible link between doxycycline and symptoms such as depression, suicidal ideation and suicide attempts. This study appears to be the first to identify psychiatric risks in children; Previous reports documented several serious psychiatric reactions to doxycycline in adults.’
It is not clear why doxycycline or other drugs in this class might have this effect, but previous studies suggest that they may trigger complex interactions with chemicals in the brain that control mood and mental well-being, altering their mechanism so quickly and seriously which in some cases leads to sudden mental deterioration.
Another possibility is that levels of the stress hormone cortisol in the brain increase, which somehow negatively affects behavior.
David Healy, a former professor of psychiatry at Bangor University in Wales, who was consulted as an expert witness by the coroner in Darren and Alana’s cases, first raised concerns about the possible harmful effects of doxycycline in 2013.
He told Good Health: ‘There is accumulating evidence that doxycycline can cause problems. I don’t know if the EMA will say that we should mention this on the drug label. But even if it were, it wouldn’t make much of a difference; As a result, doctors will not change the way they practice.
‘They hand out this medicine for acne, respiratory infections or malaria, and never warn patients.
“I don’t think doxycycline should be banned, but doctors should tell patients: ‘If at any time you feel psychologically unwell while taking the medication, stop taking it immediately.'”
At Darren’s funeral, family and friends carried his coffin, draped in the colors of Oldcastle football club (his local team), to the field where he so often played.
‘It was one of the largest funerals ever seen in this area,’ says Jim, who has met with EMA representatives carrying out the review to give a detailed account of what happened to his son. “Sometimes we go and sit in his room and hold his football jersey to our face just to smell him. We know nothing will bring him back, but doing nothing is not the answer.
‘All we want is safer prescribing guidelines. If Darren had known he was taking a pill that could have made him depressed, anxious or suicidal, he would have understood how he felt, but there was nothing to warn him.’
If you or someone you know is at risk, call Samaritans for free from a UK phone on 116 123 or visit samaritans.org.
