The cause of death for Friends actor Matthew Perry was determined to be acute effects of ketamine, according to the County of Los Angeles Department of Medical Examiner.
Contributing factors in the report released Friday include drowning, coronary artery disease and the effects of buprenorphine. The manner of death was determined to be an accident.
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Following a game of pickleball the morning of October 28, Perry reportedly returned to his Los Angeles home and sent his assistant out on an errand.
When the assistant returned two hours later, Perry was unresponsive in the spa and emergency services were called.
Paramedics responded and pronounced Perry dead at the scene.
Ketamine is an dissociative anesthetic that has some hallucinogenic effects, according to the DEA. Its medical uses include the induction and maintenance of anesthesia and as a treatment for depression.
The coroner’s autopsy report noted that Perry was on ketamine infusion therapy to deal with depression and anxiety, with the most recent therapy “reportedly one and a half weeks before death”.
The autopsy report noted that the ketamine found in Perry’s system at the time of death “could not be from that infusion therapy, since ketamine’s half-life is three to four hours, or less”.
The report said the method of intake could not be determined, but trace amounts of the drug were found in Perry’s stomach.
“At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression,” the autopsy report stated.
Perry had taken drugs in the past but had been “reportedly clean for 19 months,” according to the report. The actor had openly talked about his struggles with addiction, dating to his time on the hit show Friends in the 1990s.
In his 2022 memoir, Friends, Lovers, and the Big Terrible Thing, Perry referenced his ketamine therapy.
“Taking K is like being hit in the head by a giant happy shovel,” he wrote. “But the hangover was rough and outweighed the shovel. Ketamine is not for me.”
Perry’s assistant who lives with him found him facedown in the pool, the report stated. The assistant told investigators Perry had not been sick, had not made any health complaints, and had not shown evidence of recent alcohol or drug use.