Matthew Perry's previous accounts of the drug ketamine, which has been ruled to have played a role in his death, are coming to light.
Over a month after the “Friends” star was found dead due to an apparent drowning at his California home, his cause of death was confirmed by the Los Angeles County Medical Examiner’s Office.
According to an autopsy report, Perry died of “acute effects of ketamine.” How he took ketamine is unclear, and the report states that the drug likely made Perry unconscious, which led to drowning.
“At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular over stimulation and respiratory depression," the report states.
The autopsy found several contributing factors to Perry's death, including drowning, coronary artery disease and the effects of buprenorphine, which is used to treat opioid use disorder, the Los Angeles County Medical Examiner’s Office said in a statement.
The autopsy report states that Perry had been “reportedly clean for 19 months” and had been receiving ketamine infusion therapy, an experience the actor wrote about in his 2022 memoir. Ketamine can be used to treat mental illnesses, such as depression and anxiety, and can also be used recreationally.
Perry's last known ketamine infusion therapy session was one and a half weeks before his death, according to the autopsy report.
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"The ketamine in his system could not be from that infusion therapy, since ketamine's half-life is 3 to 4 hours, or less," the report states.
What did Perry say about ketamine?
Perry opened up about his experience with ketamine therapy in “Friends, Lovers, and the Big Terrible Thing,” saying that he used the drug “to ease pain and help with depression.”
“Ketamine felt like a giant exhale,” he wrote. “They’d bring me into a room, sit me down, put headphones on me so I would listen to music, blindfold me, and put an IV in.”
He explained that the IV contained a “smidge” of Ativan and then a drip of ketamine per hour. By the end of the session, Perry said he “was like a f------- pincushion.”
“As I lay there in the pitch dark, listening to Bon Iver, I would disassociate, see things — I’d been in therapy for so long that I wasn’t even freaked out by this. Oh, there’s a horse over there? Fine — might as well be ... As the music played and K ran through me, it all became about ego, and the death of ego.”
“And I often thought that I was dying during that hour,” he continued. “Oh, I thought, this is what happens when you die. Yet I would continually sign up for this s--- because it was something different, and anything different is good.”
He described taking ketamine as “being hit in the head with a giant happy shovel,” adding, however, that “the hangover was rough and outweighed the shovel. Ketamine was not for me.”
According to the U.S. Drug Enforcement Agency, ketamine is a “dissociative anesthetic that has some hallucinogenic effects."
The drug can distort perception, lead to a feeling of disconnection from the mind and body, induce sedation, provide pain relief and cause amnesia, the DEA says.
It’s been approved by the U.S. Food and Drug Administration as an injectable, short-acting anesthetic for humans and animals.
Ketamine therapy typically uses the drug via infusion, injection or inhalation to treat mental illnesses, TODAY previously reported.
Mike Dow, a psychotherapist at the ketamine clinic Field Trip in Los Angeles previously told TODAY that it's unclear how ketamine improves symptoms of mental health conditions, but likely works by boosting feel-good chemicals, similar to traditional antidepressants, and helping form new pathways in the brain to encourage new thought patterns and behaviors.
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