LOS ANGELES –
Matthew Perry died from the acute effects of the anesthetic ketamine, according to autopsy results on the 54-year-old “Friends” actor released Friday.
The Los Angeles County Leavement of Medical Examiner said in the autopsy report that Perry also drowned in “the warm end of his pool,” but that it was a secondary factor in his October 28 death, presumed to be an accident.
People close to Perry told investigators he was receiving ketamine infusion therapy, an experimental treatment used to treat depression and anxiety. But the medical examiner said the ketamine levels in Perry’s body were in the range used for general anesthesia during surgery, and that his last treatment a week and a half earlier would not explain those levels. The drug is usually metabolized in a few hours.
The report says coronary artery disease and buprenorphine, used to treat opioid use disorder, also contributed.
The amount of ketamine found “would be enough to make him lose consciousness and lose his posture and his ability to keep himself above water,” said Dr. Andrew Stolbach, a medical toxicologist with Johns Hopkins Medicine who reviewed the autopsy report on the application from The Associated Press.
“Using sedatives in a pool or hot tub, especially when you are alone, is extremely dangerous and, unfortunately, it is fatal,” said Stolbach, who noted that ketamine and buprenorphine can be used in safe.
Perry was pronounced dead after being found unresponsive at his home in the Pacific Palisades area of Los Angeles. Investigators performed the autopsy the following day.
The actor had taken drugs in the past but had been “clean for 19 months,” according to the report.
Perry had played pickleball earlier in the day, the report said, and his assistant, who lives with him, found him face down in the pool after returning from an errand.
The aide told investigators that Perry had not been ill, had made no health complaints, and had shown no evidence of recent alcohol or drug use.
Postmortem blood tests showed “high levels” of ketamine in his system, which may have raised his blood pressure and heart rate and dulled his drive to breathe.
Buprenorphine, commonly used in opioid addiction and found in therapeutic levels in Perry’s blood, may have contributed to the breathing problem, the autopsy said. It would have been dangerous to mix a central nervous system depressant with ketamine “because of the additive respiratory effects when high levels of ketamine are present,” according to the autopsy report.
The report said his coronary artery disease would have made him more vulnerable 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 on the megahit NBC sitcom “Friends.”
His teammates, like many of his friends, family and fans, were shocked by his death, and paid loving tribute to him in the following weeks.
Perry has been open about discussing his struggles with addiction dating back to his time on “Friends.”
“I loved everything about the show but I was struggling with my addiction which only added to my sense of shame,” he wrote in his memoir in 2022. “I had a secret and no one could know.”
A woman whose name has been redacted in the autopsy report told investigators that Perry had been in good spirits when she spoke to him a few days earlier, but that he had been taking testosterone shots which she said made him “angry and in moderation.” He said he had quit smoking two weeks earlier.
The woman said that he had been receiving the ketamine infusions for his mental health, and that his doctor had been giving them to him less often because he had been feeling well.
Ketamine is a powerful anesthetic approved by US health regulators for use during surgery, but in the past decade it has emerged as an experimental treatment for a range of psychiatric and difficult-to-treat conditions, including depression, anxiety and chronic pain.
Although not approved by regulators, doctors are free to prescribe drugs for these alternative uses if they think their patients might benefit, and hundreds of clinics across the US offer ketamine infusions and other formulations on for various health conditions.
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AP Medical Writer Carla K. Johnson in Washington state, Health Writer Matthew Perrone in Washington, DC, and Ryan J. Foley in Iowa City, Iowa, contributed reporting.
