A 21-year-old male died by hanging on 9 December 2018 following arrest for drink-driving with a blood alcohol concentration of 0.155g/210L. He had been prescribed sertraline 50mg by his GP on 7 November 2018 for depression, which showed improvement at review on 28 November. The coroner found Dr C.'s treatment appropriate, including early follow-up within three weeks and assessment for suicidal ideation (none identified). The death occurred after an acute stressor (licence suspension) combined with acute alcohol intoxication. The coroner noted that while SSRIs carry a small increased risk of treatment-emergent suicidality in under-25s (first 1-2 months), early follow-up and specialist review if needed are appropriate safeguards. GPs should remain cognisant of this risk and conduct early monitoring. Police handling was considered appropriate; there were no indicators of imminent self-harm at the time of police contact.
AI-generated summary and tagging — may contain inaccuracies; refer to original finding for legal purposes.
possible treatment-emergent suicidality (small statistically significant risk)
stressful life event coinciding with alcohol intoxication
disinhibiting effect of alcohol on suicidal ideation
Coroner's recommendations
GPs should be cognisant of the potential for treatment-emergent suicidality in people aged under 25 years when prescribing SSRIs, especially in the first 1-2 months
Early follow-up is important both to monitor efficacy of the SSRI and assess for treatment-emergent suicidality
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