Matthew Perry died of 'acute effects of ketamine,' autopsy says

Matthew Perry, the "Friends" actor who publicly struggled with drinking and drug use for decades, died from "the acute effects of ketamine," the Los Angeles County medical examiner said in an autopsy report that was released Friday, months after he was found dead at his home.

Perry was found unresponsive in a hot tub October 28. He was 54.

The coroner's office said Perry, who also had the opioid buprenorphine in his system, had drowned in an accident. The report said that he also had coronary artery disease. The medical examiner also listed the effects of buprenorphine as a contributing factor in his death.

Ketamine is a powerful anesthetic that has become increasingly popular as an alternative therapy for depression, anxiety, post-traumatic stress disorder and other hard-to-treat mental health problems. The Food and Drug Administration issued an alert in October warning about the dangers of treating psychiatric disorders with compounded versions of the drug.

The autopsy report said that Perry had been "on ketamine infusion therapy" and that his most recent therapy was about a week and a half before he died. The report noted that the ketamine in his system when he died could not have been from that infusion therapy, since the drug's half-life is three to four hours, or less.

The autopsy results had taken months to reach, and in October, experts cautioned it would take a considerable amount of time to thoroughly conduct a toxicology screening and examine other evidence.

Immediately following Perry's death, and because of his celebrity status, detectives from the county's robbery and homicide division conducted a preliminary investigation and later said they had seen no indication of foul play.

In the days following Perry's death, the department said on its website that an announcement of Perry's cause of death had been "deferred." That typically indicates that further investigation is needed; Perry's case was later removed from the website altogether.

Dr Judy Melinek, a forensic pathologist unaffiliated with the investigation into Perry's death, said that test results can take weeks because of a lack of qualified toxicologists, funding and equipment.

"It's appropriate for it to take long," Melinek said in an interview in October. "Sometimes it takes months to do a proper investigation."

Perry did not shy away from speaking publicly about his struggles with drinking and drug use, which sometimes led to hospitalizations for a range of ailments. By his own account, Perry had spent more than half of his life in treatment and rehab facilities.

In his 2022 memoir, "Friends, Lovers and the Big Terrible Thing," Perry shared in detail some of the health challenges he faced over the years, including a series of medical episodes in 2018 that included pneumonia, an exploded colon, a brief stint on life support, two weeks in a coma, nine months with a colostomy bag and more than a half-dozen stomach surgeries.

Perry was 24 when he was cast in Friends, a show that would forever change his life and one that would firmly plant his feet in the limelight. That sitcom ran for 10 seasons from 1994 to 2004, and eventually earned him and his co-stars $1 million per episode. During "Friends," Perry starred in a number of movies, some of which failed to capture audiences at the box office, including Almost Heroes (1998) with Chris Farley, and Three to Tango (1999).

After Perry's death, tributes from fans and friends washed over the internet, many remembering him for his acting talent, kindness and bravery in the face of his challenges. His fellow Friends cast mates said in a joint statement that they were "utterly devastated" by Perry's sudden death. "We were more than just cast mates," the statement said. "We are a family."

A private funeral for Perry was held November 3, according to People. The outlet said a service was held at Forest Lawn Memorial Park, a cemetery where many of Hollywood's biggest stars were buried, including Debbie Reynolds, Paul Walker and Bob Barker.