Matthew Perry's autopsy report reveals death from "acute effects of ketamine" and subsequent drowning, according to the Los Angeles Medical Examiner's Office.

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Perry's blood tested positive for ketamine, a substance known to treat depression and anxiety.

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“At the high levels of ketamine found in his postmortem blood specimens, the main lethal effects would be from both cardiovascular overstimulation and respiratory depression,” the report states. The death was ruled an accident, according to the report.

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Matthew Perry was discovered floating face down in his Pacific Palisades home pool on October 28, with authorities ruling out foul play.

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The 54-year-old actor, found unconscious in a stand-alone jacuzzi, was reportedly undergoing ketamine infusion therapy for depression and anxiety, according to the autopsy report.

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Ketamine, known for its dissociative nature, is used medically as an anesthetic and is also a recreational drug with short-duration hallucinatory and psychedelic effects.

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According to the autopsy, Perry received his last known treatment a week and a half before he passed away, which is far sooner than the amount of time the medication would have remained in his system.

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According to the investigative summary of Perry's autopsy report, his live-in assistant returned from running errands to find his unconscious body in the pool.

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“The assistant jumped into the pool, moved the decedent into a sitting position on the steps, and called 911,” says the report.

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Drowning is considered a contributing factor to Perry’s death “due to the likelihood of submersion into the pool as he lapsed into unconsciousness,” the autopsy states.

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“The assistant did not report any recent illnesses, complaints, drinking, or drug abuse,” the report states.

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What medical experts are saying

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Ketamine is a powerful medication used in hospitals primarily as an anesthetic, although studies have also found that it has significant promise in treating severe depression, anxiety and suicidal ideation. It can be used illegally as a club drug that creates an intense high and dissociative effects.

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In 2019, the US Food and Drug Administration approved a close relative called esketamine, which is used as a nasal spray, for treatment-resistant depression.

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Experts say that although the levels of ketamine in Perry’s system were very high, it’s unclear whether they would have been deadly on their own.

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Dr. Ed Boyer, a professor of emergency medicine at the Ohio State University Wexner Medical Center, said that “the elevated concentrations of ketamine suggest high levels of use.”

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“Considering his last ketamine therapy was at least a week before, misuse – even recreational use – cannot be ruled out,” he added

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Dr. Victor Weedn, a professor in the George Washington University Department of Forensic Sciences, said that people can react differently to different levels of ketamine and that it could become fatal because of its effects on breathing.

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Perry was ‘happy’ and ‘heathy’ before his death

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Perry was open about his past experience with addiction. While promoting his book “Friends, Lovers, and the Big Terrible Thing: A Memoir,” which was released in November 2022 and addressed his addiction at length, Perry said on the “Q With Tom Power” podcast, “The best thing about me, bar none, is that if somebody comes to me and says, ‘I can’t stop drinking, can you help me?’ I can say ‘yes’ and follow up and do it.”

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The autopsy report this week notes that Perry had reportedly not used drugs for 19 months before his death. It also states that though he was a “heavy tobacco user for many years,” he was not a smoker when he died.

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His “Friends” costar Jennifer Aniston said this month that she had been in contact with Perry on the day of his death, and that he “was happy.”

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“I was literally texting with him that morning, funny Matty,” she said in an interview with Variety. “He was not in pain. He wasn’t struggling.”

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“He was happy. He was healthy,” she added. “He had quit smoking. He was getting in shape.”

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