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Matthew Perry Died From Acute Effects Of Ketamine, Medical Examiner Says

A man in a V-neck sweater with his arms crossed, sitting on a red velvet couch and smiling at the camera.
Matthew Perry poses at a photocall for "The End Of Longing", a new play which he wrote and stars in at The Playhouse Theatre, on Feb. 8, 2016 in London, England.
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Friends actor Mathew Perry died from the “acute effects of ketamine,” according to the Los Angeles County medical examiner, which released the autopsy report on Friday.

The report also cited other factors in Perry’s death, including drowning, coronary artery disease and the effects of buprenorphine, which is used to treat opioid use disorder. The medical examiner also ruled the actor’s death accidental.

Perry was found unresponsive at his home in a hot tub on Oct. 28. He was 54.

Ketamine or “Special K”

Ketamine is controversial and has been used for decades as a painkiller and an anesthetic during surgery.

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Recently, psychiatrists and clinics have been using ketamine to treat patients with treatment-resistant or extreme cases of depression. It’s also used as a recreational drug in party settings for its dissociative and potentially psychedelic effects.

The autopsy report states that Perry was “on ketamine infusion therapy” less than two weeks before his death.

It’s unclear how Perry ingested the ketamine, according to the autopsy report. It also states that he had been receiving ketamine infusion therapy for depression and anxiety, but the “high levels” in his system couldn’t have been from the therapy.

Also noted in the report was that Perry’s last ketamine treatment was more than a week before his death, and that the drug’s half-life is only a couple of hours.

Ketamine was developed as a human and animal anesthetic in the 1960s. And almost from the time it reached the market it has also been used as a party drug.

That changed in 2006, when researchers at the National Institutes of Health showed that an intravenous dose could relieve severe depression in a matter of hours. Since then, doctors have increasingly prescribed ketamine "off label" to depressed patients who don't respond to other drugs.

Pharmaceutical companies soon brought new ketamine-related drugs to the market to treat depression. Johnson & Johnson received approval for its nasal spray esketamine in 2020, though it is limited to a doctor’s office or clinic.

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Ketamine can be ingested in the body in multiple ways. Powdered ketamine can be snorted or smoked, typically in marijuana or tobacco cigarettes. Liquid ketamine is injected or mixed into drinks, according to the DEA.

Other medical factors

Other factors in Perry’s death included drowning, coronary artery disease and the effects of buprenorphine, which is used to treat opioid use disorder. The medical examiner also ruled the actor’s death accidental.

Although buprenorphine wasn't at toxic levels, it can cause respiratory distress. The autopsy report said those respiratory impacts were amplified when it was mixed with the ketamine.

The effects of Perry’s coronary artery disease was also exacerbated by the ketamine, the medical examiner added.

The autopsy concludes that Perry likely slipped into unconsciousness and drowned.

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