We have been inundated with comments and questions regarding the safety of ketamine due to the tragic death of Matthew Perry. In my opinion, the coroner’s decision to list the immediate cause of death as, acute ketamine toxicity, was meant to sensationalize Perry’s history of addiction. Typically, in such a case, the immediate cause of death would be listed as drowning. This would then be followed by a line that reads, due to or as a consequence of: ____________ which is where the underlying cause would be listed. For example, drowning was listed as the immediate cause of Whitney Houston’s death, not her drug use. The same for Dennis Wilson of the Beach Boys who drowned but had a very high blood alcohol content.
As CNN Chief Medical Correspondent, Dr. Sanjay Gupta explained, the ketamine likely caused dissociation and lack of bodily awareness, which tragically led Mr. Perry to drown while in his hot tub… Dr. Gupta continues to say that ketamine …in and of itself, is not likely to lead to someone to die except for the fact that he was also in a pool… (Link to Dr. Gupta’s interview)
I know reports about ketamine deaths can raise concerns over the safety of this treatment. However, it’s important to understand Mr. Perry’s case in context. In addition to the last therapeutic ketamine infusion he received a week and a half before his death, he was obviously self-administering ketamine as a recreational drug. This is based on ketamine’s very short half-life and the fairly high levels found in his blood. The ketamine he received during his last infusion would have long been out of his system. Even though we do prescribe ketamine for use at home, the dose is far lower than what Mr. Perry would have consumed. In addition, the informed consent our patients sign specifically states another adult needs to be present when it is taken.
Please feel free to reach out if you have any other questions or concerns. When administered properly, ketamine therapy remains an extremely safe and effective treatment option. As always, our highest priority is the wellbeing, health, and safety of our patients.
Richard L. Bowen, MD