What are the acute effects of ketamine, Matthew Perry’s cause of death?

Matthew Perry's autopsy report highlights the complexities of his death, showing how a combination of factors, including the acute effects of ketamine, ultimately led to his passing. (Screen grab from F.R.I.E.N.D.S.)

Matthew Perry, the famous sitcom star who played Chandler Bing in F.R.I.E.N.D.S., passed away at the age of 54 on October 28, 2023. Recently, a medical examiner from the County of Los Angeles shared in the brief autopsy report that the cause of Perry’s death was “acute effects of ketamine” along with other exaggerating factors such as “coronary artery disease, drowning, and buprenorphine effects”. It was further said that he had a “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."

Matthew Perry (Photo via Wikimedia Commons)

Coronary artery disease (CAD), diabetes and chronic obstructive pulmonary disease (COPD) are all conditions that require lifelong management - COPD is a long-term serious lung disease.

Ketamine was prescribed to Perry to treat for anxiety and depression. The other drug found in his body, Buprenorphine, is used to treat substance-use disorder, especially for opioids.

Perry’s death was documented as an accident with a set of complex interactions of multiple factors. So, what role did ketamine play in Perry’s demise and what exactly are the “acute effects of ketamine?”

Ketamine or ketamine hydrochloride is usually given as an anesthetic, alone or in combination with other medications. However, it is also used in treating people with depression and suicidal ideation. It also reverses the toleration of opioids. While ketamine itself is not considered highly addictive, it can sometimes interact with other medications or pre-existing medical conditions to cause serious side effects, including respiratory failure.

Acute effects of ketamine

“Acute effects of ketamine” refers to the immediate or short-term effects of the drug that contributed to his death. It is important to note that the effects of ketamine are dose-dependent, and also vary based on how it is administered, the age, health status, and pre-existing health conditions of the person taking the drug. These effects may include dissociation, pain alleviation, psychedelic effects, neural changes, changes in mood and cognition, respiratory failure, increased blood pressure and heart rate, and in rare cases, seizures.

Neural effects: impaired neural responses can cause the body to not respond even in life-threatening conditions.

Dissociation: a feeling of detachment from oneself and the surrounding environment, possibly including distorted hearing and vision.

Pain alleviation: as a known analgesic, it blocks pain signals in the brain.

Cognition and mood changes: ketamine is a mood elevator initially and decreases anxiety, but it can also cause confusion, amnesia, and impaired coordination.

Cardiovascular effects: ketamine increases blood pressure and heart rate.

Respiratory depression: ketamine slows down breathing and can potentially lead to respiratory failure, especially when there are other medications or pre-existing conditions involved, such as in Perry’s case.

Psychedelic effects: at higher doses, ketamine can induce vivid dreams, hallucinations, and out-of-body experiences.

Seizures: although rare, ketamine can trigger seizures but at very high doses.

While ketamine was present in Perry's system, it's crucial to derive narratives away from a singular cause. The combination of factors ultimately led to his tragic passing. Matthew Perry's autopsy report sheds light on the complex factors that contributed to his tragic death. Here are some key takeaways:

Drowning: Perry was found unconscious in a hot tub, and the report suggests the effect of ketamine on his nervous system might have impaired his ability to respond to being underwater.

Coronary artery disease: This pre-existing condition was possibly further exaggerated by the cardiovascular effects of ketamine.

Buprenorphine: This medication for opioid use disorder was present in his system at therapeutic levels, but the report states it could have contributed to respiratory depression due to its potential interaction with ketamine.

Overall, the autopsy report highlights the complexities of Perry's death, showing how a combination of factors, including the acute effects of ketamine, ultimately led to his passing. It serves as a reminder of the importance of responsible medication use and careful monitoring of potential interactions, even for therapeutic purposes.

Perry was a talented actor and a beloved icon for many. His legacy lives on in his work and contributions to the world of entertainment.