Matthew Perry’s passing, is an incredibly unfortunate event. He is an example of an individual who struggled throughout life with various substance use disorders, and he dedicated his life to helping those with similar difficulties. In only the last few years, we’ve come a long way in this country, with speaking openly about mental illness, and showing compassion for those who suffer. He was a man before his time – judged by the public, for struggling with addiction, and none-the-less working as a force to help others in similar predicaments, for the last several decades.
I’ve never evaluated Matthew Perry. I could never claim to know the events leading to his passing. The only reason why I feel comfortable making any comments, is because he was open about his struggles. I believe that he likely did so, because he unselfishly, believed that opening up, could motivate others to get the help that they needed.
With that being said, recent knowledge made public, about the cause of his death, allows for discussion about not only addiction, but concerns that I have with the mental health landscape. Matthew Perry was found dead in his jacuzzi, deemed an accidental drowning due to the effects of ketamine.
Ketamine is a dissociative anesthetic, which is also used for depression treatment. It has been used as a recreational drug, specifically a “club drug,” for decades, and street names include “special k,” “super acid,” “purple” and “kit kat.” Forums will describe its effects as “better than acid” as its effects as a hallucinogen last about 30- 60 minutes, as opposed to hours.
I want to make it clear, that ketamine is an incredibly effective anti-depressant for some individuals, specifically, those who suffer from severe depression- including those with suicidal thoughts. For many, it has been literally life-saving. At this time our practice does not prescribe ketamine, but frankly, we are considering making it an option, for patients with significant illness. I do not know why Mr. Perry was taking Ketamine, and if he was utilizing this medication, as prescribed by a physician (which very well may have been the case). I want to make it a point to say, that anyone who suffers from depression, should be able to utilize any FDA approved medication for symptom relief, while under a doctor’s care. Patients deserve that, as depression is a terrible medical illness, that I wouldn’t wish upon anyone.
Unfortunately, I have the concern that many individuals do not realize that ketamine, carries significant health risks, just like any other medication. This unfortunate event, makes it very clear, that ketamine’s properties as a sedative, could result in someone falling asleep, or having other adverse effects, increasing risk of death. This medication should NEVER be taken when someone is anywhere near a body of water, operating heavy machinery, or in another situation, where sedation could result in death. Additionally, it can cause significant changes in EKGs (heart rhythms), vital signs (increased blood pressure for example, leading to heart attacks or strokes) and other side effects, that can cause death within a short period of time after administration.
Finally, I’ve noticed a trend where many on-line companies and even in-office providers, are prescribing higher than necessary doses (or at least higher than medical literature suggests is needed doses) for patients who are under their care. Again, I do not know what specifically occurred leading to Mr. Perry’s death. Literature suggests that doses of 50 – 100 mg or so, may have the same benefit as doses of 500 or even 1000 mg. Yet, many on-line companies are writing prescriptions for patients, with doses of 500, 600, 800 or more mg per dose, which will increase sedation, respiratory suppression, and risk of death, by accident (which we may have seen here). I am also concerned, that companies and providers are purposefully prescribing higher than necessary doses to treat depression, knowing that patients are more likely to have the “club” experience with the medication, or more likely to become addicted, as opposed to writing for the minimally effective dose, to treat their underlying mental health disorder. Ketamine (or any psychiatric medication) should be used to help those who are suffering, not to increase bottom lines, at the expense of increased side effects, and even accidental death, by patients only wishing to receive symptom relief, from a terribly distressing mental health disorder.
Again, I have never evaluated Mr. Perry. I do not know what dose of Ketamine that he took, or why he was taking ketamine. I do not know if it was prescribed by a physician or taking it as directed. But I do know, that Ketamine is a medication with the potential for serious adverse effects, and it is being prescribed at an alarmingly increased rate, by companies that are making a fortune. Mr. Perry’s last 20 + years of life were dedicated to helping those in need, and I believe that even in his death, he will continue to promote discussion and education about mental health treatment.