An autopsy report released by the Los Angeles County medical examiner on Friday said the death of “Friends” actor Matthew Perry, who was found face down and unresponsive in a hot tub at his home on Oct. 28, resulted from the “acute effects” of ketamine, an anesthetic with psychedelic properties.
Ketamine has become increasingly popular as a therapy for treatment-resistant depression and other mental health issues. It is also used recreationally.
Mr. Perry had publicly acknowledged his long struggle with alcohol and drug use, but the report said he had been sober for 19 months and little was known about his relationship to ketamine.
What is ketamine, and is it legal?
Ketamine is an injectable, short-acting dissociative anesthetic that can have hallucinogenic effects at certain doses. It distorts perceptions of sight and sound and makes users feel detached from pain and their surroundings.
Ketamine is rarely lethal, but an overdose can cause unconsciousness and dangerously slowed breathing, according to the Drug Enforcement Administration. The amount of ketamine found in Mr. Perry’s system was extremely high, comparable to an anesthetic dose, the medical examiner’s office wrote.
Side effects like increased blood pressure and paranoia are rare and typically occur at very high doses. Frequent users of the drug can develop bladder problems.
The F.D.A. in October issued a warning about the dangers of using compounded versions of ketamine. Compounded drugs are those that have been modified or tailored in a lab for the specific needs of an individual patient.
Mr. Perry had been undergoing medically supervised ketamine infusion therapy for depression and anxiety, and he had received an infusion a week and a half before he died, according to the autopsy report. The medical examiner’s office determined that treatment was unrelated to his death because the drug remains in the system for just a few hours.
Although the report did not say so, that suggests Mr. Perry was using ketamine at home at the time of his death.
Law enforcement authorities did not find any ketamine at his home, the medical examiner said.
The report did not detail the exact sequence of events that led to Mr. Perry’s death, but it cited three contributing factors: drowning, coronary artery disease and buprenorphine, a prescribed medication that he was taking to treat opioid addiction.
“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 report read.