(TNS) — The death of actor Matthew Perry in October from ketamine has prompted new concerns and scrutiny focused on unapproved uses of the drug.
Ketamine is used as an anesthetic in hospitals, where it has a long history of safe usage. It also has been abused as a recreational drug. Most recently, it has shown promise as an alternative treatment for unusually difficult cases of mental illnesses, including depression, anxiety, post-traumatic stress disorder and obsessive-compulsive disorder.
Although it’s not FDA-approved for psychiatric illnesses, doctors can legally prescribe it as an off-label treatment.
Meanwhile, a pandemic-era waiver allows doctors to prescribe ketamine via telemedicine without an in-person exam. Some patients receive ketamine at clinics or at home in the presence of a therapist, and some use it unsupervised at home.
Perry battled alcohol and drug addiction for all of his adult life. He was open about his struggles, detailing his dozens of treatment stays and the profound toll of addiction on his health.
Perry, 54, had been getting ketamine infusions legally from a clinic to treat depression. However, an autopsy determined the ketamine found in his body after his death on Oct. 28 couldn’t have been from his most recent known treatment, because too much time had passed, according to The New York Times, which reviewed the autopsy report.
While the Los Angeles medical examiner ruled that ketamine was the primary cause of his accidental drowning in a hot tub, other contributors included heart disease and buprenorphine, which is commonly used to treat opioid addiction and sometimes as a painkiller. The ketamine would have accelerated his heart rate while slowing his breathing, according to the medical examiner.
In October — several weeks before Perry’s death — the FDA published a warning about ketamine, citing risks including abuse, increased blood pressure and bladder problems, and risks of using it at home without a health care provider being present.
The U.S. Drug Enforcement Administration was already working on new rules that would limit use of telemedicine to prescribe drugs including ketamine.
Deaths such as Perry’s are considered rare. Still, it has prompted new discussion and concern. The American Society of Ketamine Physicians, Psychotherapists and Practitioners called the star’s death “a wake-up call for ketamine practitioners and the wider medical community to put clear and unified guardrails in place guided by real-world data and medicine,” the Washington Post reported. The non-profit group said it would devise guidelines for using ketamine at home.
According to MedPage Today, psychiatrist Drew Ramsey of Spruce Mental Health in Jackson, Wyoming, wrote on social media: “In clinical settings, ketamine is known for its safety profile. That doesn’t mean it is safe.” Ramsey also “cited celebrity, substance use disorders, character pathology, psychedelic medicine, and concierge medicine” as possible factors in Perry’s death.
Adam Kaplin, chief scientific officer for Mira Pharmaceuticals, cited by The Washington Post, believes ketamine has great potential to help people with psychiatric illnesses said Perry’s death shows “it is a very potentially dangerous practice to give patients access to this at home.”
At the same time, assorted start-ups are working to increase access to ketamine for people with hard-to-treat depression and other mental illnesses.
One point of contention centers on those who believe the drug should be used only in the presence of a trained therapist, and others who say the treatment will be unaffordable for many patients if they aren’t allowed to use it at home, according to the Post.
