Matthew Perry’s official cause of death has been ruled the acute effects of ketamine, according to the County of Los Angeles Medical Examiner.

Weeks after the actor’s death, the Los Angeles County Medical Examiner’s Office released the official report on Friday, December 15. Perry, whose cause of death was previously deferred by the medical examiner on October 29 pending further toxicology results, had undergone ketamine infusion therapy for depression and anxiety prior to his death, TMZ reported. However, the outlet stated that the ketamine in Perry’s system at the time of his death “could not be from that infusion therapy, since ketamine’s half-life is 3 to 4 hours, or less.”

The beloved actor was 54 when he was found unresponsive in a hot tub at his Pacific Palisades home on October 28. Initial reports said Matthew had died due to an apparent drowning – a term referenced in dispatch audio obtained by TMZ October 29.

The Los Angeles City Fire Department pronounced Matthew dead on the scene, and detectives from the Los Angeles Police Department’s Robbery-Homicide Division began a preliminary investigation.

Matthew was found with no obvious signs of trauma, according to an official statement released by the LAPD the weekend of his death.

Less than a week before he died, the Fools Rush In star posted his last photo to Instagram, featuring him in his jacuzzi. The photo was captioned, “Oh, so warm water swirling around makes you feel good? I’m Mattman.”

The actor’s friend and pickleball coach, Matt Manasse, said Matthew was “in good spirits” the day he died. The pair played together that morning, as they did four to five times a week, according to the coach in an October 29 interview with Entertainment Tonight.

“He seemed like he was in a really good place and a happy place,” Matt told the outlet about the actor’s demeanor the day of his death.

An outpouring of heartfelt tributes came from Matthew’s former castmates in the wake of his death. However, an insider told In Touch his Friends costar Jennifer Aniston was hit the hardest by the news.

“In recent years, Jen spoke to Matthew the most of anyone in their old gang, but she still wishes she could’ve done more to help him,” the source said on November 15.

The 17 Again actor recalled Jennifer’s concern about his alcohol consumption on the set of Friends in his 2022 memoir, Friends, Lovers, and the Big Terrible Thing.

“‘I know you’re drinking,’ she said,” he wrote. “‘We can smell it.’” the Serving Sara star replied at the time, “‘I know I’m drinking too much, but I don’t exactly know what to do about it.’”

Though his Friends castmates tried to help Matthew get sober early on, it was “totally beyond their realm,” according to the insider. “They didn’t feel equipped to handle Matthew’s substance abuse,” the source said.

Now, the insider concluded, the only thing Matthew’s loved ones can do is grieve.

“They know it’s pointless to blame themselves for not doing more for Matthew,” the source said. “He never blamed anyone for his problems but himself. They just can’t believe he’s gone. He was a sweet guy who deserved a lot more than he got.”

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