“I'm not great at the advice. Can I interest you in a sarcastic comment?”

This is what ‘Friends’ actor Matthew Perry’s character Chandler Bing was known for. He was known for being funny. However, he had his own struggles in his personal life and those struggles were acute depression. He was treating it with ketamine infusion therapy which is legal in the US and the UK.

What is Ketamine infusion therapy?

Ketamine is an anaesthetic used to treat depression, anxiety and pain under supervised and controlled medical settings. However, it does have its side effects, which can lead to distortion of sight, sound and time. It can also produce calming and relaxing effects.

Ketamine increases a person’s heart rate and blood pressure. If overdosed, it can leave users confused and agitated and can cause them to hurt themselves without even realising it. It can also lead to liver damage and bladder problems.

However, when used in moderation and under the supervision of medical doctors, it can treat depression where traditional antidepressants have failed.

Prof Rupert McShane, a University of Oxford psychiatrist who runs an NHS ketamine treatment clinic told BBC that ketamine “probably turns off the area of the brain that is involved in disappointment.”

Can Ketamine Infusion Therapy Kill Someone?

In simple terms, it cannot, be if the dosage is given in a controlled setting and as prescribed. Ketamine infusion therapy uses drugs in small doses than those used for anaesthesia. It acts faster than traditional anti-depressants, but the effects also wear off way quickly. Which is why it is important to monitor patients’ mental state for relapsing back into depression and discouraging them from overdosing on it.

There are ways of giving people ketamine. One of the ways is through “infusing”, which means to use an IV drip. However, injections, nasal sprays and capsules are also methods used to give people ketamine.

Since the dosage of ketamine used in the infusion treatment is small, it being the reason of actor Perry’s death was ruled out. The medical examiner also noted that Perry’s last ketamine infusion therapy session happened more than a week before his death, which means by the time he had died, it must have worn off.

So, What Happened To Perry?

Though Perry’s last session was more than a week before, his post-mortem showed that his blood contained a high concentration of ketamine. He had died of the “acute effects” of ketamine.

If it was not his session, then how did he get ketamine?

Prosecutors alleged that his assistant gave him at least 27 shots of ketamine in four days before his death, reported BBC.

Perry has been open about his personal struggles and this is what the doctors and dealers used against him. Martin Estrada, the US attorney for California’s Central District told the BBC that people took advantage of his condition. They charged him 165 times more than what vials of ketamine cost.

Names that have come up include Dr Salvador Plasencia, drug dealers “Ketamine Queen” aka Jasveen Sangha and Eric Fleming, and Perry’s live-in assistant Kenneth Iwamasa.

Who Are These Names And What Did They Do?

Ketamine Queen or Sangha supplied drugs that led to Perry’s death. Her home was a “drug-selling emporium,” said Estrada. More than 80 vials of ketamine, and thousands of pills including methamphetamine, cocaine and Xanax were allegedly found in her house known as the “Sangha Stash House.”

Sangha is known to deal with high-end celebs and was a “major source of supply for ketamine to others as well as Perry,” said Estrada.

Dr Plasencia called Perry a “moron” while charging him $2,000 for vials that cost only $12. He sold Perry 20 vials of ketamine between September and October 2023, costing $55,000.

He was the one who taught Iwamasa, who had no medical knowledge to inject the drug. This is after he knew that “Perry’s ketamine addiction was spiralling out of control,” as per what the investigators told the BBC.

Another dealer Fleming was told by Sangha to “delete all our messages.” While Fleming pleaded guilty to conspiring to distribute drugs unlawfully, he also allegedly messaged Sangha: “Please call...Got more info and want to bounce ideas off you. I’m 90% sure everyone is protected. I never dealt with [Perry] only his assistant. So the assistant was the enabler.”

The court documents also revealed that he asked Sangha on whether the ketamine stays in your system or “is it immediately flushed out.”

Dr Pepper, Bots, Cans

The people who allegedly exploited Perry used coded language for ketamine and called it “Dr Pepper”, “bots”, or “cans.”

Selling overpriced drugs, taking advantage of Perry’s mental condition and falsifying medical records to make the drugs given to him look legitimate by Dr Plasencia is what took Perry’s life.

Iwamasa is said to have administered more than 20 shots of ketamine and three on the day Perry died. Whereas ketamine is only administered by a physician. Authorities also found that weeks before Perry’s death, Dr Plasencia allegedly bought 10 vials of ketamine and intended to sell to Perry.

He also injected Perry with a large dose, two days later. This caused him to “freeze up” and spiked his blood pressure.

When I Die, I Want Helping Others To Be The First Thing That’s Mentioned

Perry had always been open about his drug addictions, struggles with alcohol and his depression. He said that his openness would help others who are also struggling and wanted to be remembered by his quote which also is on the homepage of the Mattew Perry Foundation that helps others struggling with the disease of addiction: “When I die, I want helping others to be the first thing that’s mentioned.”

Five arrests have been made in the case so far.

Indians are popping antacids like candies, and they are putting their hearts, kidneys and gut health at risk. Doctors from time and again have cautioned patients to not take such pills without prescriptions.

Antacids are prescribed proton pump inhibitors or PPIs, used commonly to reduce the amount of acid in the stomach and helps to treat and prevent various acid related conditions. However, in India, acidity is not treat as a symptom, but a lifestyle condition, which has made these pills so common. These over the counter access also created medical complacency, this means the availability has blurred the line between short term relief and long term therapy.

How does antacid impact your kidney health?

Repeated use is increasingly associated with acute interstitial nephritis and chronic kidney disease. What makes this dangerous is that kidney damage often develops silently, discovered only when kidney function has already deteriorated significantly.

How does antacid impact your gut health?

It also impact the gut microbiome, and causes chronic digestive problems. Stomach acid regulates gut bacteria. Suppressing it allows harmful bacteria to flourish, leading to bloating, infections, diarrhea, and conditions like small intestinal bacterial overgrowth (SIBO).

How does antacid impact your bone health?

Furthermore, regular usage of antacids could make your bones weak too. As per a 2023 study published in the journal BioMed Research International, pantoprazole cause bone loss, which could be prevented by adding octreotide.

The study analyzed the serum levels of calcium, phosphorus, and ALP before starting the treatment, and at the end of 12 weeks of treatment on pantoprazole, significant decline in calcium levels were noticed, as compared with other groups. The study also found that octreotide significantly prevented the effect of pantoprazole on the serum levels of calcium and ALP.

The study also found that pantoprazole decreased femoral bone density and femoral BMAD. Besides this, another decrease was found in the femoral bone weight and volume as well as the trabecular volume.

How does antacid impact your heart health?

Frequent heartburn is also a symptom of gastroesophageal reflux disease or GERD. This is a condition in which the valve between the stomach and the lower esophagus malfunctions and allows stomach acid to bubble up into the esophagus. This is often treated with antacid, which may mask the real problem.

Over time, untreated GERD can injure the lining of the esophagus and increase the risk of serious complications, including Barrett’s esophagus, a condition that can raise cancer risk. Also, symptoms often blamed on heartburn, such as chest pain or burning, can sometimes signal a heart attack. That’s why experts stress getting a proper medical evaluation before self-treating with antacids.

The safer alternatives are:

Famotidine (Pepcid, Calmicid, Fluxid, Mylanta AR) is a potent H2 blocker used to manage acidity and heartburn. Studies show that famotidine is not thought to raise the risk of osteoporosis.

Other options: Ranitidine (Zantac - where available, as it was withdrawn in some markets due to safety concerns) and Nizatidine are other H2 blockers.

Note: Health & Me do not encourage discontinuance of any prescribed medicine by a doctor. Before making any change in your medicine schedule, please speak to your doctor/GP.

Nasal spray warnings are given by doctors and experts as the long use of it could lead to worsening of condition. The Royal Pharmaceutical Society (RPS) advised the public to not use nasal decongestant for more than seven days, as it contains xylometazoline or oxymetazoline. Its prolonged use can cause 'rebound congestion' or increased dependency on these sprays to breathe easily.

A recent poll, reports the Independent found out that almost six in 10 pharmacists report patients were unaware of the dangers of its extended use. Due to the increased number of flu activity, symptoms like blocked nose has increased, which has lead to a high usage of nasal spray.

Is Rebound Congestion Preventable?

It is a preventable condition, and is scientifically known as rhinitis medicamentosa, which causes the symptoms to worsen. Patients become depended on the sprays to breathe more easily.

RPS survey of 300 pharmacists found that 59% think the public is not aware of the risks, while 75% said packaging should be clearer about the seven-day limit. 63% said they had intervened in cases of suspected overuse.

Professor Amira Guirguis, chief scientist at RPS told the ITV News, "Nasal decongestant sprays can be helpful for short-term relief, but using them for longer than seven days can make your congestion significantly worse. Our research shows that many people are unaware of this risk, which means they may continue using these sprays without realizing they could be prolonging their symptoms. We'd like to see clearer warnings on the packaging which you can't miss and greater awareness of the seven-day limit. If your congestion lasts more than a week, speak to your pharmacist. There are safe and effective alternative options to help you manage your symptoms."

Another survey by ITV News suggests that more than a fifth of adults have used the products for longer than seven days. This means 5.5 million people in the UK may have risked developing a dependency.

Read: Bristol Hospitals Under Severe Strain as Flu and Cold Weather Hit the Region

As ITV News reported, Charlotte Johnstone, who is 30, had been using nasal spray multiple times a day since she was seven years old. She realized that the impact of this so-called addiction has caused her anxiety and left her "dreaming about not being able to breathe". She told ITV News, “I can’t sleep without having it, I wake up and the first thing I do is have my nasal spray. I don’t like eating if I’ve got a blocked up nose, it just makes me feel claustrophobic. I wouldn’t put myself in a situation where I don’t have it. “I go through stages of losing my sense of smell. I know it’s doing something but I don’t know what. But for the sake of having a clear nose, I’ll just take it,” she said.

A spokesperson from PAGB, the consumer healthcare association representing the manufacturers of these products, said: “The patient information leaflet which accompanies all nasal decongestant sprays, includes these instructions and outlines the risks of taking the medication for longer than its indicated use. As explained on the information supplied with the nasal decongestant sprays, OTC medicines manufacturers provide comprehensive accessible information to support people to make responsible informed decisions about the right product to self-care for their self-treatable condition," reported ITV News.

Open AI launched a new ChatGPT feature in the US, called the ChatGPT Health. As of now, this is launched only in the United States, which can analyze people's medical records and give them better answers. However, it has also drawn attention of critics, who raise concerns regarding the privacy, as well as safety of diagnosis and treatment.

What Is ChatGPT Health?

As per the Open AI website, "Health is a dedicated space in ChatGPT where you can ask health and wellness questions and choose to connect your health data (like medical records and wellness apps) so responses can be grounded in that context. It is designed to support, not replace, medical care."

One can access Health from the sidebar and can ask health-related questions in a main chat. OpenAI has said that the conversations in ChatGPT Health would be stored separately to other chats and would not be used to train its AI tools. The feature will also not be used for "diagnosis or treatment".

However, Andrew Crawford, of US non-profit the Center for Democracy and Technology, as reported in the BBC said, it was "crucial" to maintain "airtight" safeguards around users' health information. "New AI health tools offer the promise of empowering patients and promoting better health outcomes, but health data is some of the most sensitive information people can share and it must be protected," Crawford said.

Why Is This Feature Being Introduced?

OpenAI notes that more than 230 million people ask its chatbot questions related to health and wellbeing, at least every week. Thus the feature is being launched, while ChatGPT Health will have "enhanced privacy to protect sensitive data".

Open AI also noted that users can connect it with third party wellness apps to get the data, for instance Apple Health, Peloton, and MyFitnessPal. These apps can provide the medical records to OpenAI's new feature to generate relevant responses.

In a blogpost, Open AI noted: "You can securely connect medical records and wellness apps to ground conversations in your own health information, so responses are more relevant and useful to you. Designed in close collaboration with physicians, ChatGPT Health helps people take a more active role in understanding and managing their health and wellness—while supporting, not replacing, care from clinicians."

Will This Feature Replace Doctors?

OpenAI claims that ChatGPT Health is not launched to replace medical care, rather to help one navigate everyday questions and understand patterns over time. OpenAI claims that the tool was developed in close collaboration with physicians.

In the last two years, OpenAI said that it was able to work with more than 260 physicians across 60 countries and dozens of specialities, who have provided feedback on model outputs more than 600,000 times.

While the feature is only launched in the United States, however, the company said that it plans to make Health available to all users on web and IOS "in the coming weeks" as the experience is refined.