Almost three weeks have passed since Friends actor Matthew Perry was found dead at his Los Angeles home on October 28. While the initial investigation into the actor's cause of death was inconclusive, the Los Angeles County Department of Medical Examiner has now released an autopsy report that confirms the actor’s death as an accident and reveals he passed away from “the acute effects of ketamine." Contributing factors are drowning, coronary artery disease, and the effects of buprenorphine, which is "an opioid-like drug used in the treatment of opioid addiction as well as acute and chronic pain," according to the autopsy report.
The toxicology report adds, “At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression."
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What Is Ketamine?
Speaking with the OnlyMyHealth team, Dr Joydeep Ghosh, Consultant, Internal Medicine, Fortis Hospital, Anandapur, Kolkata, said, "Ketamine is a potent anaesthetic agent that is used for general anaesthesia procedures."
According to the United States Drug Enforcement Administration (DEA), a dissociative drug contains some hallucinogenic effects that distort the perception of sight and sound and make the user feel disconnected and out of control.
Ketamine Infusion Therapy For Depression
Currently, ketamine treatment is popular among psychiatrists for treating major depression, said Dr Ghosh, adding that ketamine infusion therapy can help treat depression that is difficult to treat, also known as treatment-resistant depression.
A 2006 study published in the journal JAMA Psychiatry found that people who received ketamine showed significant improvement in depression in just a matter of hours.
The US Food and Drug Administration (FDA) approved the use of Spravato (esketamine) for treatment-resistant depression in 2019.
Reportedly, Perry had been undergoing ketamine infusion therapy for depression and anxiety. He had started the therapy session approximately a week and a half before his death, as per the autopsy report, which also clarifies, “the ketamine in his system at death could not be from that infusion therapy, since ketamine’s half-life is 3 to 4 hours, or less."
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Potential Health Risks
Ketamine treatment is generally safe when administered under the supervision of an aesthetician or a psychiatrist, said Dr Ghosh. It may cause certain side effects, which include:
- Nausea and vomiting
- Disorientation
- Dizziness
- Increased blood pressure
- Heart palpitation
- Changes in sensory perceptions
- A feeling of detachment

According to the American Addiction Centers (AAC), long-term use of ketamine can lead to the development of a substance use disorder, which refers to the condition in which a person is unable to control their use of substances like legal or illegal drugs, alcohol, or medications.
Therefore, Dr Ghosh advised proper evaluation of patients by doctors to check if they really require ketamine treatment or not.
He concluded that there should be a very rigid structure to monitor the patients throughout the infusion and during the post-infusion phase.