How helpful or harmful is ketamine? 5 things to know after Matthew Perry's death

Matthew Perry's 2023 death from what the Los Angeles County medical examiner's office determined were 'the acute effects of ketamine' cast a shadow over a medication that has been enjoying growing popularity as therapy for depression and other mental health conditions.

Matthew Perry’s 2023 death from what the Los Angeles County medical examiner’s office determined were “the acute effects of ketamine” cast a shadow over a medication that has been enjoying growing popularity as therapy for depression and other mental health conditions.

(The report listed drowning as a contributing factor; Perry was found face down in a hot tub at his home.)

The actor’s death raised questions about how ketamine is being used — and possibly misused — in a largely unregulated landscape that some critics liken to the “Wild West” due to a proliferation of clinics around the country. Perry, who had struggled for years with drug addiction, had been open about receiving ketamine therapy for depression.

“Matthew Perry sought treatment for depression and anxiety and went to a local clinic where he became addicted to intravenous ketamine,” Anne Milgram, the Drug Enforcement Administration’s administrator, said at a recent press conference. “When clinic doctors refused to increase his dosage, he turned to unscrupulous doctors who saw Perry as a way to make quick money.”

Prosecutors said a underground network of drug sellers and suppliers — including two doctors — were responsible for distributing the ketamine that killed Perry. Five people have been charged in connection with the death of the “Friends” actor. Three are cooperating with prosecutors, while two defendants have pleaded not guilty to respective charges that include falsifying medical records and conspiracy to distribute among others.

To be clear, ketamine is only approved by the U.S. Food and Drug Administration as an anesthetic and not for the treatment of any psychiatric disorder. (The FDA approved a related drug, esketamine, sold as Spravato, in 2019 for people with treatment-resistance depression.)

But the scientific evidence showing that ketamine can be helpful in patients with treatment-resistant depression and suicidal ideation is strong and goes back at least 20 years.