Darren took a common antibiotic used for acne infections – two weeks later he was dead

Every morning, before leaving the house for work, Jim Connell stops at a table in his hallway, 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 the happy times together,” says Jim, 47, from Oldcastle in County Meath in the Republic of Ireland.

And every night before he goes to bed, Jim – who is married to 49-year-old Vera, with whom he has four more children – does the same thing again. “My last thought before I go to sleep is always Darren – and I know it’s the same for Vera,” says Jim, who works in the dairy industry.

In September 2019, just a few weeks after his 17th birthday, Darren took his own life.

It came so out of the blue that the family was completely at a loss to explain why their charismatic and popular son, who was looking forward to studying sports science at university and had no history of depression, would commit suicide.

In September 2019, just a few weeks after his 17th birthday, Darren took his own life

“He was always looking ahead – incredibly driven and such 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 being told by school that he had not shown up.

But in the search for clues as to what led to Darren’s tragic loss, one clear suspect quickly emerged. Just two weeks before his death, Darren’s GP had prescribed him a drug called doxycycline to treat acne, after he developed a few spots on his face.

The antibiotic – which he had never taken before – has been around since the 1960s and is used by tens of millions of people worldwide for everything from chest 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 people with no history of mental illness. In Darren’s case, he went from a vibrant, optimistic and fitness-mad teenager to yet 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 ever think this would happen to,” Jim says. “We racked our brains to see if there were any signals we missed.”

But it’s not just his distraught parents who blame the drug.

In October last year, the County Meath coroner’s report into Darren’s death described the evidence that doxycycline played a role in Darren’s death as ‘compelling’ and appealed to the Health Products Regulatory Authority (which oversees the safety of medicines in the Republic). consider whether the patient information leaflets for doxycycline should be revised to warn about the risk of sudden suicidal tendencies.

Now Good Health can reveal that the European Medicines Agency (EMA) – which investigates the safety and effectiveness of prescription medicines across the European Union – is investigating the psychiatric safety of doxycycline.

The agency announced on its website in July that it was reviewing evidence about the drug because of a “steady stream of reports” that previously mentally stable people were killing themselves, often within days or weeks of starting the drug.

At the start of the study, the EMA said: ‘Recent concerns have been raised about the potential neuropsychiatric side effects of doxycycline, particularly in relation to suicidality.

Some research has suggested a possible link between doxycycline and increased risks of depression and anxiety, known risk factors for suicidality. Assessing this potential association is critical to understanding the full safety profile of doxycycline and ensuring patient safety.”

The research 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 took the coffin – draped in the colors of Oldcastle football club (his local team) – to the field where he so often played.

If the EMA determines that doxycycline poses an increased risk – as the victims’ families suspect – it may require that the packaging and package leaflets warn of the possible dangers.

Any changes are likely to influence the UK regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), to do the same here. Currently, doxycycline’s labeling does not mention any mental health or suicidal risks.

Darren’s story bears worrying similarities to that of Alana Cutland, the 19-year-old University of Cambridge student who fell from a light aircraft 1,500 meters above Madagascar in July 2019 after taking doxycycline for 11 days to ward off malaria. keep out.

Alana, who was studying biological sciences, was on a research trip and fell ill within days, showing signs of paranoia and withdrawing. Her worried parents had arranged a flight home, and the plane took her to the airport.

At her inquest, Milton Keynes coroner Tom Osborne concluded – after consulting with experts examining the effects of doxycycline on psychiatric wellbeing – that the drug caused a ‘psychotic reaction’ and called on the MHRA to review the information given to patients was given to review the dangers of doxycycline.

In a statement to Good Health, the MHRA said it is ‘continually monitoring’ the safety of all medicines – ‘including the potential safety signal associated with doxycycline and the risk of suicidal ideation’.

It added: ‘Any new evidence is routinely considered, together with other sources of information, including suspected adverse reactions.’ But while 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 from China Pharmaceutical University published a review of the safety of a class of antibiotics called tetracyclines – which also includes doxycycline, which is often used to treat acne – for children aged eight to 18.

Researchers reviewed nearly two decades of data from the U.S. Food and Drug Administration’s Adverse Event Reporting System, a catalog of adverse events reported by doctors and patients.

Their findings, published in the journal Frontiers in Pharmacology in July, showed that for side effects such as skin reactions or abdominal complaints, 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 the more than 1,900 side effects of all kinds, 44 were cases of suicidal thoughts or attempts – and doxycycline was responsible for 35 of these. Minocycline, on the other hand, was linked with eight, tigecycline none.

The researchers said: ‘Our study indicates a potential increase in psychiatric risks associated with doxycycline use in children, which is not currently addressed in 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 severe psychiatric reactions to doxycycline in adults.”

It is unclear why doxycycline or other drugs in this class can have this effect, but previous studies suggest that they can cause complex interactions with brain chemicals that control mood and mental well-being, disrupting their mechanism so quickly and severely that it in some cases leads to sudden mental deterioration.

Another possibility is that they increase the level of the stress hormone cortisol in the brain, which somehow negatively affects behavior.

David Healy, a former professor of psychiatry at Bangor University in Wales who was consulted by the coroner as an expert witness in both Darren and Alana’s cases, first raised concerns about the possible harmful effects of doxycycline in 2013.

He told Good Health: ‘There is increasing evidence that doxycycline can cause problems. I don’t know if the EMA will say that we have to mention this on the label of the medicine. But even if it does, it won’t make a big difference; Doctors will therefore not change their way of working.

‘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 mentally unwell while taking the drug, stop taking it immediately.’

At Darren’s funeral, family and friends took the 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 burials ever seen in this area,” says Jim, who has met with EMA representatives conducting the investigation to provide a detailed account of what happened to his son . ‘Sometimes we sit in his bedroom and hold his football jersey close to our face just to smell his scent. We know nothing will bring him back, but doing nothing is not the answer.

‘All we want are safer prescribing guidelines. If Darren had known he was taking a tablet 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 in danger, call the Samaritans for free from a UK phone 116 123 or visit samaritans.org.