Matthew Perry died from acute effects of ketamine, officials rule

LOS ANGELES — Matthew Perry died from acute effects of ketamine, a drug sometimes used to treat depression, officials said.

The ketamine caused cardiovascular overstimulation and respiratory depression, the Los Angeles County Medical Examiner said. Other contributing factors in Perry’s death include drowning, coronary artery disease and the effects of buprenorphine, a medication used to treat opioid use disorder.

His Oct. 28 death was an accident, according to an autopsy.

Perry was found unresponsive at his residence. After 911 was called, paramedics responded to the scene and he was pronounced dead.

On Oct. 29, the deputy medical examiner completed an autopsy on Perry.

After a pickleball game on Oct. 28 he returned home, law enforcement sources said, and at some point got into his hot tub. It was there that an assistant found him unresponsive and called 911 around 4 p.m.

Perry was undergoing ketamine infusion therapy every other day for a period of time but had reduced that intake more recently and had not received an official infusion for a week and a half before his death.

The medical examiner noted that the presence of ketamine would not be expected, however, as it typically disappears from the system in detectable amounts within three to four hours. Trace amounts were found in Perry’s stomach, the medical examiner noted, and the level found in his blood was about the same quantity as would be used during general anesthesia.

The medical examiner also noted that Perry, 54, had diabetes and suffered from chronic obstructive pulmonary disease, which refers to a group of diseases that cause airflow blockage and breathing-related problems. He also smoked two packs of cigarettes a day.

According to the U.S. Drug Enforcement Administration, ketamine can be used to treat depression. As a “dissociative anesthetic hallucinogen,” it can make patients “feel detached from their pain and environment” and can induce a state of sedation and amnesia.

In 2006, the National Institute of Mental Health concluded that an intravenous dose of ketamine had rapid antidepressant effects. About 300 clinical trials have been held, and they have broadly found that ketamine is extremely fast-acting compared with traditional antidepressants and can relieve depression for a period that can last days or weeks.

A prescription version of ketamine called Spravato, given through a nasal spray, was approved in 2019 by the FDA for treatment-resistant depression. The number of ketamine clinics in the U.S. has risen from a few dozen to several hundred in the last few years.

Perry described taking ketamine infusions in his memoir, “Friends, Lovers, and the Big Terrible Thing.”

“It’s used for two reasons: to ease pain and help with depression. Has my name written all over it — they might as well have called it ‘Matty,’” he wrote. “Ketamine felt like a giant exhale. They’d bring me into a room, sit me down, put headphones on me so I could listen to music, blindfold me, and put an IV in.”

He wrote that he would “disassociate” while listening to music and “often thought that I was dying during that hour.”