LOS ANGELES (AP) — Matthew Perry died from the acute effects of the anesthetic ketamine, according to autopsy results of the 54-year-old “Friends” actor released Friday.
The Los Angeles County Department of Medical Examiner said in the autopsy report that Perry also drowned in the “heated end of his swimming pool,” but that this was a secondary factor in his died October 28, considered an accident.
People close to Perry told investigators he was suffering ketamine infusion therapy, an experimental treatment used to treat depression and anxiety. But the medical examiner said the levels of ketamine in Perry’s body were within the range used for general anesthesia during surgery, and that his last treatment, a week and a half earlier, would not explain not these levels. The drug is usually metabolized within a few hours.
The report said coronary heart disease and buprenorphine, used to treat opioid use disorder, also contributed.
The amount of ketamine detected “would be enough to cause him to lose consciousness and loss of posture and ability to stay above water,” said Dr. Andrew Stolbach, a medical toxicologist at Johns Hopkins Medicine, who examined the autopsy report on request. from the Associated Press.
“Using sedative medications in a pool or spa, especially when you are alone, is extremely risky and, unfortunately, here it is deadly,” said Stolbach, who noted that ketamine and buprenorphine can be used in completely safe.
Perry was pronounced dead after being found unresponsive at his home in the Pacific Palisades neighborhood of Los Angeles. Investigators performed the autopsy the next day.
The actor had used drugs in the past, but was “19 months clean,” according to the report.
Perry had been playing pickleball earlier in the day, according to the report, and his assistant, who lives with him, found him face down in the pool after returning from shopping.
The aide told investigators that Perry had not been ill, made no health complaints and showed no evidence of recent alcohol or drug use.
Post-mortem blood tests showed “high levels” of ketamine in his system, which could have increased his blood pressure and heart rate and blunted his impulse to breathe.
Buprenorphine, commonly used in opioid addiction and present at therapeutic levels in Perry’s blood, may have contributed to the breathing problem, according to the autopsy. It would have been risky to mix the central nervous system depressant with ketamine “due to additive respiratory effects when present with high levels of ketamine,” according to the autopsy report.
The report said his coronary heart disease would have made him more sensitive to the effects of the drugs.
Perry was among the biggest TV stars of his generation when he played Chandler Bing alongside Jennifer Aniston, Courteney Cox, Lisa Kudrow, Matt LeBlanc and David Schwimmer for 10 seasons from 1994 to 2004. The hit NBC sitcom “Friends.”
His comrades, like many of his friends, family and fans, were stunned by his death, and paid him an affectionate tribute in the weeks that followed.
Perry was open about discuss their struggles with addiction going back to his time on “Friends.”
“I loved everything about the show but I was struggling with my addictions, which only added to my sense of shame,” he wrote in his 2022 memoir. “I had a secret and no one could know.”
A woman whose name is redacted in the autopsy report told investigators that Perry was in good spirits when she spoke to him a few days earlier, but that he was taking testosterone injections that she said made him “angry and mean”. She said he had quit smoking two weeks earlier.
The woman said he was receiving ketamine infusions for his mental health and his doctor was giving them to him less often because he felt good.
Ketamine is a powerful anesthetic approved by health regulators in the United States for surgical use, but over the past decade it has become an experimental treatment for a range of psychiatric and difficult-to-treat illnesses, including depression, anxiety and chronic pain.
Although they are not approved by regulators, doctors are free to prescribe drugs for these alternative uses if they think their patients would benefit from them, and hundreds of clinics across the United States offer infusions of ketamine and other formulations for various health conditions.
AP Medical Editor Carla K. Johnson in Washington state, Health Editor Matthew Perrone in Washington, D.C., and Ryan J. Foley in Iowa City, Iowa, contributed to this report.