What is ketamine infusion therapy?

One of the details that emerged Thursday about actor Matthew Perry’s death is that the Friends star was undergoing ketamine infusion therapy.

The Coroner concluded that the treatment – offered both in the US and the UK – was not responsible for Perry’s death due to ketamine, which prosecutors allege was given to him illegally.

Five people including two doctors, Perry’s assistant and an alleged drug dealer are accused of providing the drug outside of his treatment.

Perry, 54, was open about his history of drug abuse, and prosecutors say the defendant profited from his addictions.

What is ketamine?

Ketamine is a drug that can be used to treat depression, anxiety and pain in medical settings.

However, it also has dissociative effects – meaning it can distort the perception of sight, sound and time, as well as producing calming and relaxing effects. This means that it is also used illegally.

According to addiction advice service Talk to Frank, Ketamine can increase a person’s heart rate and blood pressure, and can leave users confused and disorientated – which can lead them to unintentionally harm themselves. be careful.

Chronic use of ketamine is associated with liver damage, as well as causing bladder problems such as incontinence.

What is ketamine infusion therapy?

Ketamine is used to treat depression in cases where traditional anti-depressants have not been effective.

Dr Rajalingam Yadhu, a consultant at the Royal Free Hospital in London who also runs Save Minds, a ketamine infusion therapy clinic, told the BBC that the patients he treats have long-term depression and have often tried at least seven different remedies without seeing. improvement.

“These are people who have tried everything in life, [are] who are very suicidal – and given the chance, they are.”

The treatment is also used by the elite. Along with Perry, billionaire entrepreneur Elon Musk said he was prescribed ketamine to treat depression.

In an interview with CNN in March, the owner of X and Tesla said that the drug “helps to get a person out of a bad memory”.

How does ketamine infusion therapy work?

Ketamine infusion therapy works by giving the drug intravenously in smaller doses than those used for anesthesia.

“For depression, you use a lower dose than you use for chronic pain, a much lower dose than what patients receive as narcotics,” says Dr. Mario Juruena, a doctor at psychiatry at King’s College London who specializes in treatment-resistant mental illnesses.

Ketamine works faster than traditional anti-depressants – but its effects wear off quickly.

“It has a short half-life, so the time that patients have the effect is sometimes short,” Dr Juruena told the BBC, stressing the importance of monitoring patients’ mental status to return to depression.

Dr Yadhu says that, unlike other common anti-depressants, ketamine has been found to affect nerves that use the chemical glutamate to interact. Glutamate is the most abundant neurotransmitter in the nervous system.

Experts are researching why it may help some patients but not others.

Dr Juruena told the BBC that more than 60% of patients responded well to ketamine treatment – but said this often happened while taking other anti-depressants or in combination with psychotherapy.

Both warned that people could still experience adverse effects from taking ketamine, even under the supervision of a medical professional – although Dr Juruena said this was often due to the low dose.

Dr Yadhu says that while many of his patients’ experiences were positive, some were unpleasant and can bring back bad memories.

He also said he does not treat people who show signs of addiction to ketamine – although some doctors are testing it as a treatment for drug and alcohol addiction.

Receiving ketamine by “infusion” – ie through an IV drip – is not the only way to treat people with ketamine, however.

Dr Juruena says it can also be given by injection, nasal spray or as a capsule.

Why is ketamine treatment prescribed outside of Perry’s disease?

Experts say that the dose of ketamine given in infusion therapy must be precise and small to have anti-depressant effects.

But a post-mortem examination found that Perry’s blood contained high levels of ketamine and that he died from the “severe effects” of the drug.

The medical examiner also found that his last ketamine infusion treatment occurred more than a week before his death – by which time the drug would have worn off.

They said the levels of ketamine in Perry’s body at the time of his death were also very high.

Prosecutors said Perry’s assistant gave him at least 27 shots of ketamine in the four days before his death.