Matthew Perry’s fatal dose: Ketamine crisis in the spotlight

Matthew Perry, the actor best known for his role as Chandler Bing on Friends, tragically passed away on October 28, 2023. His death shocked many fans and sparked renewed focus to the ways in which substances like ketamine are being used recreationally.

Jasveen Sangha, 41, along with four others, was arrested and charged in August for allegedly supplying the Friends star with the ketamine that led to his death.

The other suspects include Perry’s personal assistant, Kenneth Iwamasa, his acquaintance Erik Fleming, and two doctors, Salvador Plasencia and Mark Chavez.

The indictment further alleges that Iwamasa administered at least six doses per day on 25, 26, and 27October, before administering the final, fatal three doses on 28 October.

An indictment unsealed in Los Angeles federal court revealed that Iwamasa and Fleming collaborated with the doctors to acquire significant amounts of ketamine for Perry in the months leading up to his death, The Independent reported.

Ketamine: Lifeline for depression or dangerous gamble?

Ketamine holds the promise of life-saving relief for those battling severe depression or suicidal thoughts when conventional treatments fail. But without medical supervision, this powerful drug can be dangerously addictive and even lethal.

The South African Society of Psychiatrists (Sasop) is sounding the alarm about the risks of unsupervised and recreational ketamine use. It’s urging caution as its popularity grows in independent clinics.

The drug shows promise as a treatment for severe, treatment-resistant depression and acute suicidal ideation. Ketamine can offer life-saving benefits.

However, it should be administered under strict medical supervision. Misuse or high doses pose serious risks of addiction and even death, said Sasop spokesperson, psychiatrist Dr Bavi Vythilingum.

Ketamine: A double-edged sword in depression treatment

Ketamine, an anaesthetic used in humans since the 1970s and listed by the World Health Organization as essential, has demonstrated efficacy in low doses for treating severe depression.

Nevertheless, when not properly managed, ketamine can cause dangerous sedation and loss of consciousness. In extreme cases, is can slow down breathing that may be fatal.

At lower doses, lack of supervision can lead to confusion and accidental self-harm. Its potential for addiction and abuse is also a concern.

The rising trend of independent clinics offering ketamine treatment for mental health issues raises concerns about proper diagnosis, treatment appropriateness, and management of side effects.

Sasop emphasises that ketamine is only recommended for adults with treatment-resistant depression. It cautions against its use in children and for conditions like Post Traumatic Stress Disorder (PTSD) and Obsessive–Compulsive disorder (OCD).

Trance-like states, hallucinations, and sensory distortions

Ketamine is administered via intravenous infusion over 40-50 minutes, followed by recovery time. Initial treatments typically involve six sessions over two to three weeks, with possible maintenance sessions.

The drug can induce dissociative experiences, including trance-like states, hallucinations, and sensory distortions, making a safe, supervised environment crucial.

Potential side effects include nausea, elevated blood pressure, respiratory issues, sedation, and, with long-term use, bladder, kidney, and liver problems. Addiction risk may lead to increasingly higher, dangerous doses.

Sasop stresses that ketamine should only be prescribed and administered by a qualified psychiatrist or medical doctor. This should happen in a facility equipped for monitoring and managing adverse effects.

Guidelines from the South African Society of Anaesthesiologists (SASP) should be followed to ensure the safety and efficacy of treatment.

Further research is needed to fully understand ketamine’s long-term effects and safety as a psychiatric treatment.

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