Matthew Perry’s cause of death has been released.
The Los Angeles County Medical Examiner on Friday revealed that the late “Friends” actor‘s death in October was an accident, with the cause being “the acute effects of ketamine.” Contributing factors were drowning, coronary artery disease and the effects of buprenorphine.
Buprenorphine is “an opioid-like drug used in the treatment of opioid addiction as well as acute and chronic pain,” according to Perry’s 29-page autopsy report obtained by USA TODAY. There were no signs of “fatal trauma and no foul play suspected,” according to the report.
Ketamine’s role in Matthew Perry’s death
The autopsy, conducted the day after his death, describes Perry as a “54-year-old male with history of chronic obstructive pulmonary disease/emphysema, diabetes; drug use in past — reportedly clean for 19 months; heavy tobacco user for many years but currently not smoking; on ketamine infusion therapy with most recent therapy reportedly one and a half weeks before death.”
The medical examiner makes note that the amount of ketamine, a “dissociative anesthetic,” found in his system was as high as 3,540 nanograms per milliliter; “levels for general anesthesia are typically in the 1,000-6,000 ng/ml ranges,” the report notes.
Though Perry was “reported to be receiving ketamine infusion therapy for depression and anxiety,” according to the report, “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.”
What is ketamine treatment? Sharon Osbourne says ketamine helped her depression
Perry was 54 years old when he died Oct. 28. He was found unresponsive and face-down in the “heated end” of his pool, according to his autopsy. The Los Angeles Fire Department confirmed to USA TODAY that firefighters responded to Perry’s Pacific Palisades home at 4:07 p.m. that day and found “an adult male unconscious in a stand-alone jacuzzi.”
“A bystander had brought the man’s head above the water and gotten him to the edge, then firefighters removed him from the water upon their arrival. A rapid medical assessment, sadly, revealed the man was deceased prior to first responder arrival,” Nicholas Prange, an LAFD spokesperson, told USA TODAY in a statement on Oct. 30.
According to his autopsy, there were no pills, drugs or medications found near the pool. He didn’t have alcohol or drugs such as methamphetamine, cocaine, heroin and fentanyl in his system.
How does ketamine work as an antidepressant?
Ketamine is an FDA-approved anesthetic, and over the past few decades, it’s also been hailed for its fast-acting antidepressant effects.
In 2019, the FDA officially approved esketamine, or ketamine nasal spray, for depression – specifically major depressive disorder with suicidal ideation and treatment-resistant depression (meaning that at least two alternative antidepressant treatments failed).
Dr. Nolan Williams, an assistant professor in Stanford University’s Department of Psychiatry and Behavioral Sciences, previously told USA TODAY that it’s unclear exactly how ketamine affects mood, because “there are many mechanisms happening at once.” But rather than affecting dopamine or serotonin, neuroscience studies show that ketamine instead targets a neurotransmitter called glutamate, which promotes the brain’s ability to create lasting, new lifestyle patterns.
Some experts have also speculated that the dissociative experience of a ketamine “trip” may be responsible for reducing depressive symptoms. Though there’s no evidence that the trip directly affects mood, Dr. Alexander Papp, a board-certified psychiatrist and voluntary clinical professor at UC San Diego, says some of his patients have credited ketamine’s psychedelic properties to their improved outlook on life.
How is ketamine abused? And what is “Special K”?
The painkiller Ketamine can be used as a sedative or treatment for depression, but it’s also known as a “club drug” that can produce “dissociative sensations and hallucinations,” according to the Drug Enforcement Administration.
Ketamine first caught interest as a counterculture drug in the 1970s and re-emerged as a club drug “Special K” in the 2000s.
How many ketamine treatments do you need?
Itzkoff says each session varies by patient, but standard treatment occurs twice a week for four weeks; then, once a week for another four weeks. It can legally be administered orally or through an IV injection, but intranasal ketamine is the only FDA-approved method so far.
During the session, people often experience an altered, trancelike trip that lasts approximately one or two hours. They may also be guided with talk therapy, also known as ketamine-assisted therapy.
“When (patients) are in a very vulnerable state, we’re often trying to help them access different types of feelings,” Itzkoff says. “That is most easily done when you have a very controlled, very safe setting.” In order to keep the patient comfortable, she adds that she will offer to “dim the lights, prepare music, or give them eye shades … because ketamine can cause patients to feel a bit dizzy.”
However, Williams explains “the FDA-approved procedure for esketamine does not involve or require psychotherapy.”
Was Matthew Perry sober?
Perry was open about his battle with alcohol and drugs, which he chronicled in his 2022 memoir “Friends, Lovers and the Big Terrible Thing.” He wrote with candor and compassion and showed his dedication to continue fighting a near-fatal battle.
Jennifer Aniston said that Perry was doing well in his personal life before his death, she told Variety.
“He was happy. He was healthy,” Aniston said. “He had quit smoking. He was getting in shape. He was happy — that’s all I know. I was literally texting with him that morning, funny Matty. He was not in pain. He wasn’t struggling.”
This is a developing story. Jenna Ryu and Edward Segarra contributed.
This article originally appeared on USA TODAY: Matthew Perry cause of death revealed: How ‘Friends’ star died
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