Sandhya Prashad, MD
December 18, 2023
OFFICIAL STATEMENT FROM THE AMERICAN SOCIETY OF KETAMINE PHYSICIANS, PSYCHOTHERAPISTS & PRACTITIONERS (ASKP3)
“In the wake of Matthew Perry’s autopsy report, we are committed to creating and publishing guidelines for at-home ketamine use, which should only be practiced with a very specific patient profile and only in the context of a close relationship with a provider and in-office follow-up.”
In response to the details and tragic circumstances surrounding Matthew Perry’s death, the American Society of Ketamine Physicians, Psychotherapists & Practitioners (ASKP3) is reconfirming our long-standing position that dissociative doses of ketamine are only appropriate in supervised settings. However, we acknowledge that there are some situations in which it may be appropriate for a clinician to prescribe at-home use in between face-to-face appointments; and therefore, a unified set of guidelines must be collectively considered and put in place by ketamine practitioners across the U.S.
ASKP3, which is comprised of 500+ licensed medical professionals with extensive experience working with ketamine in a variety of medical settings, stands as the sole entity to publish practical and ethical standards for ketamine therapy during its nascent stages. In the wake of Perry’s autopsy report, we are committed to creating and publishing guidelines for at-home ketamine use, which should only be practiced with a very specific patient profile and only in the context of a close relationship with a physician and in-office follow-up.
Our forthcoming guidelines will be written by ASKP3’s think tank and faculty, which includes an international group of 35 of the world’s top doctors and therapists administering ketamine as a mental health treatment. The guidelines will include best practices for: dosing, environment, delivery mechanism, contraindications, and patient-physician communication. Telehealth models will not be included in our recommendations for safe use.
As has been reported, it appears that Perry was receiving in-office infusions for depression and anxiety and had found them helpful in his mental health struggles and recovery. A typical antidepressant dose of 0.5mg/kg administered over 40 minutes produces peak plasma concentrations of 70-200 ng/ml compared to plasma concentrations of 2000-3000 ng/ml when used for surgical anesthesia. According to toxicology reports, Perry’s plasma concentrations exceeded 3000 ng/ml.
It is not clear from where or from whom Perry retrieved such high doses of ketamine.
We want to clarify that even anesthetic doses of ketamine are not commonly reported to suppress respiration. However, such high doses will cause someone to lose consciousness and thus drown, as appears to have happened in this case. As with any medication, dose, environment, contraindications and a patient’s overall physical health are highly important factors in maintaining safety.
We ask the American public, press and regulators to remember that every 7 minutes an American dies from opioid overdose. Death from the “acute effects of ketamine” is in fact exceedingly rare in comparison. We urge patients who have found relief from mental health or chronic pain struggles with ketamine to continue with their in-office treatment plans.
We want to offer our condolences to Perry’s family, friends and the greater public who loved him and his craft. We hope to shed light on the facts while preserving patient access to this vital mental health treatment. When administered correctly and with supervision, ketamine is often one of the only solutions for patients suffering from chronic suicidality, treatment resistant depression, PTSD and chronic pain.
This is a wakeup call for ketamine practitioners and the wider medical community to put clear and unified guardrails in place guided by real-word data and medicine (as opposed to startup profits and flashy business models) in order to protect the people who need this treatment most.
The American Society of Ketamine Physicians, Psychotherapists, and Practitioners (ASKP3) is a non-profit group of professionals dedicated to the safe clinical use of ketamine for mental health disorders and pain conditions. Formed in 2016, ASKP3 represents a growing membership of over 500 multidisciplinary professionals.