A PRESCRIPTION drug a teenager took before jumping to her death from a plane while suffering a “psychotic event” still does not list the potential side effect.
Alana Cutland, 19, fell 5,00ft into thick jungle during a dream trip researching rare blue crabs in Madagascar in July 2019.
Alana Cutland, 19, died after falling from a planePA:Press Association
Ian Whittaker – The SunThe Cessna light aircraft Alana fell from[/caption]
The teenager, from Milton Keynes, cut short her six-week research trip after suffering psychosis and hallucinations understood to be caused by anti-malaria drug doxycycline.
At an inquest into her death in August 2020, Milton Keynes coroner Tom Osborne said Alana had “suffered a psychotic delirium event that led to her behaviour and death”.
He added that it was “quite apparent” that the reaction was caused by the drug – warning there was “nothing on the drug information leaflet that either highlights or mentions this possibility”.
Mr Osborne asked for a review into the information sent out to patients prescribed doxycycline.
He added: “If she or her parents have been aware of this possible side-effect they may have been able to intervene earlier to avoid her death.”
And six years on from his stark warning, the information leaflet – seen by The Sun – still fails to mention the potential side effect, sparking fresh fury.
The Medicines and Healthcare products Regulatory Agency (MHRA) has insisted, however, that a “number of reviews” have established “no causal link” between doxycycline and psychiatric adverse reactions.
But Professor David Healy, the expert witness commissioned by the Coroner for Alana’s inquest, said there are “hundreds of compelling case reports of doxycycline causing suicide”.
He told The Sun: “What we need to remember is that MHRA are a bureaucracy – like the aviation authorities.
“They licence paperwork that Boeing or pharma companies send in to them but they aren’t engineers or pharmacologists and don’t fly planes or monitor what happens to patients on meds.
“They have no training in working out how to establish a link between a drug and a problem.
“It’s pilots and doctors who keep us safe – or used to keep us safe.
“Pilots still do because they have an incentive to do so – if we don’t make it to wherever alive, they don’t either so if a door blows off a plane, they won’t fly again till the problem – not just that door is fixed.
“But doctors don’t have the same incentive.
“If you claim a problem has happened on a drug they gave you, they are now more likely to throw you out through the open door for spreading misinformation than take your side and insist drug labels mention this problem.”
Professor Healy said experts know “how and why” doxycycline causes suicide and epidemiological studies.
He added: “Doctors who go by drug labels rather than what is happening to the person right in front of them kill patients like Tom Kingston recently and Alana Cutland and others.”
Alana died on July 25, 2019, when she broke open the door of a small aircraft after fighting off the shocked pilot and researcher Ruth Johnson, who was escorting her back to the UK.
Ian Whittaker – The SunAlana was travelling home when she fell to her death[/caption]
The student was on a dream trip researching rare blue crabs in Madagascar
The student had been taking doxycycline before her death – an antibiotic that kills bacteria in the body and is prescribed by a GP.
Her devastated parents Neil and Alison previously said it was “tragic” that their daughter’s death was “essentially caused by the side effects of doxycycline”.
They said: “We realise that such drugs have an important role to play, but it shocked us to discover that such a severe side effect could be virtually undocumented.”
Doxycycline, which is prescribed to treat bacterial infections, has been authorised as an anti-malaria drug for more than 50 years.
It is taken orally every 12 hours, with prescriptions normally starting before somebody travels to a country exposed to high-risk of malaria.
In a case report published in leading medical journal The BMJ in 2019, three young people with no history of mental illness were treated for skin conditions with doxycycline.
All three developed “suicidal ideation” with an outcome of suicide in two of the cases, the report says.
Emily Darlington, MP for Milton Keynes Central, told The Sun: “My heart goes out to Alana’s friends and family.
“I am urging the Department of Health to read the coroner’s report and consider what changes should be made as a consequence of their recommendations.”
What is doxycyline?
DOXYCYCLINE is prescribed by GPs to treat bacterial infections.
It works by inhibiting protein synthesis in bacteria – meaning it stops bacteria from reproducing rather than killing them outright, giving the body’s immune system a better chance to fight off the infection.
The drug is prescribed for conditions including malaria, skin, dental and urinary tract infections, sexually transmitted infectins as well as lyme disease.
It is also used to combat acne, rosacea and other conditions such as cholera, typhus and anthrax.
Side effects include headaches, nausea and vomiting, and an increased sensitivity to sunlight.
More serious and rare side effects include allergic reactions, increased pressure around the brain and permanent tooth discolouration in young children.
The drug is usually taken by adults and children over 12 years old.
Following multiple studies in the UK and globally, a comprehensive review of all reported psychiatric events linked to the drug doxycycline was conducted by the Commission on Human Medicines.
No causal link between the drug nd psychiatric adverse reactions like acute psychosis, hallucinations, or suicidality was found, according to the review.
Last year, an EMA study of real-world data also supported these findings.
In 2020, a scientific consensus report was published by the US National Academies that said: “Based on the available evidence, the committee concludes that there is insufficient or inadequate evidence of an association between the use of doxycycline for malaria prophylaxis and persistent or latent psychiatric events.
“Current evidence does not suggest further study of such an association is warranted, given the lack of evidence regarding biologic plausibility.”
The MHRA has vowed to continue to “closely monitor reports”, however, and said it is “considering if further additional studies into this area are required”.
Dr Alison Cave, MHRA Chief Safety Officer, told The Sun: “Patient safety is our top priority.
“Our thoughts remain with Alana Cutland’s family following her tragic death.
“A number of reviews into the suspected association between doxycycline and psychiatric events have been conducted both in the UK and globally.
“These reviews have consistently not been able to establish a causal link.
“However, we continue to keep this issue under close review and will take regulatory action if new evidence emerges that changes the balance of benefits and risks.”
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