Why Was Matthew Perry Taking Ketamine? What Most People Get Wrong

The world stopped for a second on October 28, 2023. We all saw the headlines: Matthew Perry, the man who made us laugh for a decade as Chandler Bing, was found dead in his hot tub. Then came the toxicology report, and with it, a word that sparked a million questions. Ketamine.

People immediately started jumping to conclusions. Was it a relapse? Was it a party drug gone wrong? Honestly, the truth is a lot more complicated than a tabloid headline. It involves a desperate search for mental health relief, a "miracle" treatment that turned into a trap, and a group of people who saw a vulnerable man as a walking ATM.

The Medical Reason: Why Was Matthew Perry Taking Ketamine?

Matthew Perry wasn't just "partying." He was struggling. If you read his memoir, Friends, Lovers, and the Big Terrible Thing, you know he spent most of his life fighting a war against his own brain. He’d tried everything to beat depression and anxiety.

By late 2023, he had turned to ketamine infusion therapy.

This isn't some back-alley thing. Ketamine is actually an FDA-approved anesthetic that doctors have been using off-label for years to treat "treatment-resistant depression." When traditional SSRIs fail, ketamine is often the "hail mary." It works differently by targeting glutamate in the brain, often providing relief in hours rather than weeks. For someone like Perry, who had been through the ringer with every medication under the sun, it felt like a lifeline.

He was reportedly "in good spirits" and responding well to the clinical treatments.

But there’s a massive catch.

The ketamine that killed him didn't come from his doctor's office. The medical examiner was very clear about that. Perry’s last legal infusion was a week and a half before he died. Since the drug has a half-life of only about three to four hours, that clinical dose was long gone. The levels found in his system during the autopsy were astronomical—somewhere between 3,271 and 3,540 ng/ml.

To put that in perspective, that’s the same amount used for general surgery.

The Shift from Therapy to Dependence

It started out as medicine. Then it became an "out of control" dependence.

When the clinics wouldn't give him more, Perry didn't stop. He couldn't. This is the part people get wrong about addiction—it doesn't care if the drug started in a white-coat clinic or on a street corner. He began seeking it out illicitly.

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The investigation, which wrapped up with several sentencings in late 2025, revealed a dark network. We’re talking about "The Ketamine Queen" (Jasveen Sangha) and doctors who literally texted each other, "I wonder how much this moron will pay."

One of those doctors, Salvador Plasencia, was recently sentenced to 30 months in prison in December 2025. He wasn't treating a patient; he was selling vials for $2,000 a pop to a man he knew was a struggling addict.

What Actually Happened That Day?

The autopsy lists the cause of death as "acute effects of ketamine." But the drug didn't just stop his heart. It’s more of a "perfect storm" scenario.

Perry had other factors at play:

• Coronary artery disease: His heart wasn't in great shape.
• Buprenorphine: He was taking this legally to manage opioid addiction, but it’s a respiratory depressant.
• Drowning: This was the final blow.

Ketamine causes dissociation. You feel "detached" from your body. At the doses Perry was taking—administered by his live-in assistant, Kenneth Iwamasa—he likely lost consciousness or entered a "trance state." Because he was in a hot tub, he slipped under the water. He didn't have the physical or mental capacity to pull himself back up.

It’s a tragic irony. The man who spent $9 million trying to get sober ended up losing his life to a substance he originally sought out for healing.

The E-E-A-T Perspective: Is Ketamine Therapy Safe?

If you or someone you know is considering ketamine for depression, this story is terrifying. But experts like Dr. Andrew Stolbach from Johns Hopkins emphasize that when used in a controlled, medical environment, the safety profile is actually very high.

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The problem wasn't the ketamine itself; it was the lack of supervision.

Medical-grade infusions are monitored. You have a pulse oximeter on your finger. You have a nurse or doctor watching your vitals. You are not left alone in a body of water.

Perry’s case is a cautionary tale about "dual diagnosis"—having both a mental health disorder and a history of addiction. For addicts, even "good" drugs can trigger the old "more, faster, cheaper" wiring in the brain.

Moving Forward: Actionable Insights

If you’re looking into ketamine therapy or dealing with a similar struggle, here’s the real-world takeaway:

1. Vetting is everything. Only use clinics that follow the American Society of Ketamine Physicians, Psychotherapists & Practitioners (ASKP3) guidelines. If they offer at-home "lozenges" or unsupervised sessions to someone with an addiction history, walk away.
2. Full Disclosure. Never hide a history of substance abuse from a psychiatrist. The "cross-addiction" risk is real.
3. The "Water" Rule. It sounds simple, but never use dissociative or sedative substances near a pool, tub, or ocean.
4. Community over Isolation. Perry’s fatal doses happened in secret, injected by an assistant, not a medical pro. Isolation is where addiction wins.

Matthew Perry wanted to be remembered for more than Chandler. He wanted to be remembered as someone who helped people stay sober. By looking at the raw, uncomfortable truth of why he was taking ketamine, we can actually honor that wish by being smarter about how we handle mental health and the powerful tools used to treat it.

If you are struggling, you can reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) at 1-800-662-HELP. There are people who want to help, and you don't have to do it alone.