Actor Matthew Perry died from the "acute effects of ketamine," a sedative sometimes used to treat depression, with drowning and heart disease found to be contributing factors, the Los Angeles County Medical Examiner's Office reported on Friday.
The coroner's autopsy report listed "the effects of buprenorphine," a drug used to treat opioid use disorder, as a contributing factor in Perry's death, which was ruled an accident.
Perry, 54, best known for his role as Chandler Bing of the 1990s hit television sitcom "Friends," was found lifeless in the jacuzzi of his Los Angeles home on Oct. 28.
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Perry's death came one year after the publication of his memoir, "Friends, Lovers, and the Big Terrible Thing," which chronicled his decades-long bouts with addiction to prescription painkillers and alcohol, a struggle he said came close to ending his life more than once.
Ketamine, a short-acting anesthetic with hallucinogenic properties, is used recreationally mainly due to its "dissociative" nature, according to the medical examiner's report on Perry.
"The exact method of intake in Mr. Perry's case is unknown," the report said, adding that trace amounts of the drug were found in the contents of his stomach.
The ketamine in Perry's system likely overstimulated his heart rate while depressing his breathing, and he would have lapsed into unconsciousness before his face slipped below the water in the hot tub, the report said.
Perry was reported to have been undergoing ketamine infusion therapy for depression and anxiety, but his last known treatment was a week and a half before his death, so the ketamine found in his system by medical examiners would have been introduced into his body since that last infusion, the report said.
Ketamine can induce a state of feeling calm and relaxed, relief from pain, and amnesia, according to the U.S. Drug Enforcement Administration.
Referred to as a "dissociative anesthetic hallucinogen" because it makes people feel detached from their pain and environment, it can be injected, mixed with liquids, snorted as a powder, or smoked, the DEA says.