Matthew Perry Died From Effects of Ketamine, Autopsy Shows
The 54-year-old ‘Friends’ actor was found unresponsive at his California home in October
Matthew Perry died from the acute effects of ketamine, according to an autopsy of the “Friends” actor released Friday.
The 54-year-old actor was discovered unresponsive in the pool at his Pacific Palisades home on Oct. 28, according to Los Angeles police officials.
“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,” the Los Angeles County Department of Medical Examiner’s autopsy report said.
Drowning, coronary artery disease and “buprenorphine effects” also played a role in his accidental death, according to the autopsy. Buprenorphine is a medication used to treat opioid-use disorder.
Ketamine enhances the effects of opioids including buprenorphine, said Dr. Benjamin Yudkoff, medical director of the ketamine and esketamine program at Brigham and Women’s Faulkner Hospital in Boston. “There’s a greater risk of respiratory depression when you mix them,” he said.
Perry, who was open about his lifelong substance-abuse struggles, had been sober for 19 months, the autopsy report said. He was receiving ketamine infusion therapy for depression and anxiety, and his last known treatment was about a week and a half before he died, according to the report. Ketamine’s half-life, or the time it takes the amount of drug in the body to fall by 50%, is three to four hours, the report said.
Ketamine, an anesthetic, has been used in hospitals and clinics for decades to numb people during surgeries. It also has hallucinogenic properties and is used as a party drug, causing an out-of-body experience.
More recently, the drug has surged in popularity as a mental-health treatment, after some studies have shown that it can help patients with severe depression, post-traumatic stress disorder and chronic pain. Treatment clinics have popped up across the U.S., and some companies started prescribing it online during the Covid-19 pandemic.
The Food and Drug Administration hasn’t cleared ketamine as a mental-health treatment. But doctors can prescribe it for that purpose off-label because the drug is approved as an anesthetic. A similar chemical called esketamine is FDA approved for patients with treatment-resistant depression under the name Spravato.
The FDA published a warning letter in October about the potential risks of compounded ketamine products for the treatment of psychiatric disorders. Safety concerns include increases in blood pressure, slowed breathing and urinary tract or bladder problems.
Using ketamine without a health provider monitoring for sleepiness, dissociation or changes in heart rate can put patients at risk, the agency said in its letter.
“It really decreases your consciousness, and with that it can have cardiovascular changes and respiratory depression,” said Dr. Lisa Harding, a psychiatrist at the Yale School of Medicine who treats patients with ketamine. “This is a treatment that saves lives, but it has to be done with the right patient and it has to be done in the right place.”
Ketamine and other substances such as psilocybin and LSD have become popular among some tech executives and employees, who see psychedelics and similar substances as gateways to business breakthroughs.
On the day he died, Perry had played a game of pickleball, according to his assistant. The assistant later returned from running errands to find the actor floating face down in the pool, according to details included in the autopsy report. The assistant jumped in, moved the actor to a sitting position on the steps of the pool and called 911. Paramedics pulled him out and onto the grass and declared him unresponsive. The assistant didn’t note any “recent illnesses, complaints, drinking or drug abuse,” according to the report.
Perry’s death came as a shock to millions of his fans. The Massachusetts-born Canadian, with his seemingly easy humor, was a cultural touchstone for generations, along with his “Friends” co-stars. The show, which helped define the 1990s, continues to be in heavy rotation. Its stars remain familiar favorites to fans.
“He was such a part of our DNA,” Jennifer Aniston wrote in an Instagram post after Perry’s death. “We were always the 6 of us. This was a chosen family that forever changed the course of who we were and what our path was going to be.”
Perry continued to act with some success after “Friends” ended, but his struggles with drugs could be consuming. In his 2022 memoir “Friends, Lovers, and the Big Terrible Thing,” he detailed some of the cost of his addiction: 15 stays in rehab, an exploded colon, $7 million trying to get help, and living “half my life in one form or another of treatment center or sober living house.”
Perry eventually became a celebrity ambassador for the National Association of Drug Court Professionals and, for a time, operated a recovery facility out of his Malibu home.
“The best thing about me, bar none, is that if somebody comes to me and says, ‘I can’t stop drinking, can you help me?’ I can say ‘yes’ and follow up and do it,” Perry said in an interview while promoting his memoir last year. “When I die, I don’t want ‘Friends’ to be the first thing that’s mentioned. I want that to be the first thing that’s mentioned.”