In news that could cast a pall over the wider trend toward ketamine therapy, The Wall Street Journal reports that beloved "Friends" actor Matthew Perry was undergoing ketamine treatment at the time of his death — and that his use of the anesthetic likely contributed to his untimely demise.
The 54-year-old was found dead in his pool on October 28 at his Pacific Palisades home, the WSJ reports. An autopsy report says that he had died from a combination of drowning, effects from medication for treating opioid abuse, coronary artery disease, and he had high levels of ketamine in his bloodstream.
Perry was suffering from anxiety and depression and was getting therapeutic ketamine infusions at the time, the WSJ reports. Ketamine magnifies the effects of buprenorphine, the medication he was taking for his opioid disorder, in a combination that can lead to breathing problems.
The autopsy also found that Perry last received an infusion about a week and a half before his death. Ketamine in the bloodstream dissipates after a few days. So it appears that Perry procured ketamine outside his designated clinic, whether on the black market or from another medical provider.
No matter where he received ketamine, which is being increasingly used for mood disorders, some medical experts think his death should be a cautionary tale for patients and providers.
"This really should be a wake-up call that ketamine needs to be used appropriately," Yale University’s depression research program director Gerard Sanacora told the WSJ.
Historically, ketamine has been used for anesthesia and as a recreational drug. But there's been growing interest in off-label applications for a range of mental health treatments.
Back in 2019, the FDA approved a version of ketamine delivered via nasal spray for treatment-resistant depression, but its use would be under certain strict conditions because of the risk of misuse. This version of ketamine, esketamine, is missing one molecule, making it a kind of "ketamine light."
This October, the FDA released a statement warning of the dangers of compounded ketamine, supposedly a mixture specially formulated for the needs of a specific patient. Compounded ketamine is not FDA-approved for psychiatric disorders.
"Use of compounded ketamine products without monitoring by a health care provider for sedation (sleepiness), dissociation (disconnection between a person’s thoughts, feelings, and sense of space, time, and self), and changes in vital signs (such as blood pressure and heart rate) may put patients at risk for serious adverse events," the FDA said.
This government warning and Perry's death come during a whirlwind of interest around ketamine because studies have shown it is a demonstratively effective therapeutic option for depression and other mood disorders. And with this interest comes various start-ups peddling the drug, and even Silicon Valley titans like Elon Musk singing the praises of the drug.
Basically ketamine is reaching mainstream status in America. But the FDA and medical experts warn — and Perry's tragic demise illustrates — that doesn't mean its use doesn't come with dangers.
More on ketamine: FDA Warns That a Lot of "Ketamine Therapy" Seems to Just Be Partying
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