“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.

The United States Food and Drug Administration has recently approved Qfitila (fitusiran) for routine prophylaxis to prevent or to reduce the frequency of bleeding episodes in adults and pediatric patients 12 years of age and older with hemophilia. It works on those with hemophilia A or hemophilia B, with or without factor VII or IX inhibitors which neutralizes antibodies.

While subcutaneous Qfitilia does not replace the missing coagulation factor VII or IX, it reduces the amount of protein antithrombin, which leads to an increase in thrombin. It is an enzyme critical for blood clotting. The dosing starts at once every two months and it is also based on the FDA-cleared Innovance Antithrombin companion diagnostic test.

However, as of now, there is no fixed doses of Qfitila is not approved mainly due the risk excessive clotting. It has also a boxed warning for thrombotic events and gallbladder disease.

One of the most common side effects reported were viral infection, nasopharyngitis, and bacterial infection.

How Was This Approved?

The approval came on the basis of two randomized clinical trials that had 177 adult and pediatric male patients with either hemophilia A or hemophilia B enrolled. Among the participants with inhibitors who received the antithrombin-based dosing regimen of Qfitlia, there was a 73% reduction in the estimated annualized bleeding rate. This was seen in comparison with those who received on-demand treatment with bypassing agents.

Among the participants without inhibitors receiving the antithrombin-based dosing regimen of Afitlia, there was a 71% reduction in the estimated annualized bleeding rate versus that seen in those who received on-demand treatment with clotting factor concentrates.

"Today's approval of Qfitlia is significant for patients with hemophilia because it can be administered less frequently than other existing options," Tanya Wroblewski, M.D., deputy director of the Division of Non-Malignant Hematology in the FDA Center for Drug Evaluation and Research, said in a statement.

What Is Hemophilia?

As per the Centers for Disease Control and Orevention (CDC) it is an inherited bleeding disorder in which blood does not clot properly. It can lead to spontaneous bleeding as well as bleeding following injuries or surgeries. Blood usually has proteins called clotting factors that can help one to stop bleeding. However, people with hemophilia have low levels of either factor VII or factor IX.

Hemophilia could also result in bleeding within joints which can then lead to chronic joint disease and pain. It could lead to bleeding in head and in brain, causing long term problems such as seizures or paralysis. In severe cases it can also lead to death if the bleeding cannot be stopped.

The most common types of hemophilia are inherited, thus it is a condition that is present from birth. There are rare cases where hemophilia happens later in life, which is known as acquired hemophilia.

Difference between Hemophilia A and Hemophilia B

As per the National Bleeding Disorders Foundation, hemophilia A, also called factor VIII (8) deficiency or classic hemophilia, is a genetic disorder caused by missing or defective factor VIII (FVIII), a clotting protein. Although it is passed down from parents to children, about 1/3 of cases found have no previous family history.

Hemophilia B, also called factor IX (FIX) deficiency or Christmas disease, is a genetic disorder caused by missing or defective factor IX, a clotting protein. Although it is passed down from parents to children, about 1/3 of cases are caused by a spontaneous mutation, a change in a gene.

Shingles, a painful viral infection due to the reactivation of the varicella-zoster virus (VZV), is primarily known for its blistering rash and nerve pain. New research indicates, however, that shingles vaccine can be significant in preventing dementia. This recent finding paves the way to new avenues to understand the association between viral illness and brain wellness, which might change preventive treatment against cognitive degeneration in aging individuals.

Once a person has had chickenpox, he or she carries the varicella-zoster virus for life. The virus lies dormant within nerve cells and may reappear years later as shingles, commonly because of compromised immunity with age, stress, or illness.

Shingles appears as a painful rash, typically on one side of the body, and may persist for weeks. Aside from the rash, the infection may cause severe complications like postherpetic neuralgia (PHN), a long-term nerve pain syndrome that lasts for months or even years. In rare instances, shingles may infect the eye, causing blindness.

The Centers for Disease Control and Prevention (CDC) estimates that approximately 1 in every 3 Americans will develop shingles at some time during their lifetime. Vaccines have been recommended to avoid the condition, but recent studies indicate they might also have an added bonus—prevention from dementia.

Shocking Link Between Shingles and Dementia

Dementia, such as Alzheimer's disease, is a rapidly increasing worldwide health issue, with millions of older adults at risk. Although the causes of dementia are still unknown, researchers have long suspected that some viruses, specifically those in the herpes family (which includes VZV), may play a role in cognitive decline.

A study recently published in Nature determined that getting the shingles shot lowered the risk of developing dementia dramatically. Scientists followed more than 280,000 elderly people in Wales who got the original shingles vaccine, Zostavax, and identified a 20% decrease in dementia incidence over the next seven years.

Lead author Dr. Pascal Geldsetzer of Stanford University said the results were "very robust" and added that women appeared to gain more benefit from the vaccine than men. Since women are at greater risk for dementia, these results could have important implications for future prevention efforts.

Can Shingles Cause Cognitive Decline?

Although no one knows the exact mechanisms, several theories discuss how the shingles virus might enhance the risk of dementia:

Inflammation and Brain Damage: The varicella-zoster virus has the ability to cause inflammation in the body, including the brain. Chronic inflammation is recognized to speed up cognitive decline and may play a role in neurodegenerative diseases such as Alzheimer's.

Vascular Effects: The virus has the ability to infect blood vessels in the brain, leading to clots or constricting blood flow. Decreased cerebral circulation is a well-documented risk factor for dementia and stroke.

Amyloid Protein Formation: A study by the University of Colorado Anschutz Medical Campus indicates that shingles can encourage the formation of amyloid plaques, a characteristic of Alzheimer's disease. These adhesive proteins clump together in the brain, interfering with normal function and speeding up cognitive decline.

Can Shingles Vaccination Protect Against Dementia?

The research suggests that shingles vaccination can lower the risk of dementia by inhibiting reactivation of the virus and triggering inflammation in the brain. It is unclear, however, whether the same protective mechanism works for the newer, more effective Shingrix vaccine, which supplanted Zostavax in 2020.

In contrast to Zostavax, which had a live but attenuated form of the virus, Shingrix is a genetically modified vaccine that consists of certain viral proteins to stimulate an immune response. Shingrix has been 97% effective in preventing shingles in clinical trials, versus 51% for Zostavax. Whether it can help prevent dementia, however, is an open question scientists are eager to investigate.

Who Should Receive the Shingles Vaccine?

The CDC advises Shingrix for people aged 50 and above, as well as younger adults with compromised immune systems. The vaccine is given in two doses, spaced a few months apart, and is very effective in preventing shingles and its complications.

With these advantages, however, vaccine acceptance continues to be low, with less than 40% of eligible Americans having gotten their shots. The most frequent side effects are mild flu-like symptoms and pain at the site of injection, but experts point out that the advantages far outweigh the risks.

Tips for Reducing Dementia Risk

Although shingles vaccination holds great potential for dementia prevention, it is not the only answer. Experts suggest an integrated approach to brain health that involves:

Living an Active Lifestyle: Physical exercise on a regular basis enhances circulation to the brain and averts cognitive loss.

Healthy Nutrition: A diet modelled on Mediterranean cuisine, featuring high intakes of fruits, vegetables, whole grains, and healthy fats, is supportive of brain function.

Social and Mental Stimulation: Mental activity with reading, puzzles, or social engagement may build cognitive reserve.

Control of Chronic Illnesses: Control of high blood pressure, diabetes, and cholesterol lowers the risk of dementia.

The association of shingles with dementia risk demonstrates the complex ways infectious illnesses affect overall well-being. Finding that shingles vaccination can decrease risk of dementia adds yet another persuasive argument to convince older people to be vaccinated. Although more study is necessary to validate the results, the study holds out hope that a straightforward vaccine has a key part to play in maintaining cognitive capacity and enhancing the quality of life among aging groups.

As scientists continue to investigate the link between viral infections and brain health, one thing is certain: guarding yourself against shingles might have advantages that reach far beyond the skin. With the increasing global burden of dementia, interventions such as vaccination could become a key part of the arsenal in the battle against cognitive decline.

Dr. Jayanta "Jay" Bhattacharya, has officially assumed office as the 18th Director of the National Institutes of Health (NIH), bringing a new era of leadership to the country's leading medical research agency. His confirmation, approved by the U.S. Senate on March 25, 2025, represents a major change in NIH's direction, in line with President Trump's Make America Healthy Again Commission.

Dr. Bhattacharya comes on board amid widespread federal health system reorganization. HHS Secretary Robert F. Kennedy Jr. just announced a comprehensive overhaul that involves firing about 1,200 NIH staff. In an all-staff letter, Dr. Bhattacharya accepted the challenges to come, promising staff that he will make changes with compassion and openness.

"I am aware that I am coming into NIH during a period of unprecedented change. Every corner of the federal government is being scrutinized — and NIH is no exception," he wrote. Grateful for the efforts of the affected employees, he went on to say, "Many of our good colleagues are losing their jobs, and that in no way reflects the quality of their effort.". I wish to thank most sincerely those who will be impacted for all that you have done for the mission of the NIH."

Promises to Restoring Trust in Science and Research Integrity

A leading Stanford health economist and physician, Dr. Bhattacharya has been a long-time advocate for scientific integrity and academic freedom. His mission is to reaffirm public faith in biomedical studies, with priority placed on maintaining integrity, being reproducible, and being innovative in NIH-sponsored research.

Most importantly, our findings will only be impactful if the public is confident in our results and believes that we are working on their behalf," said Dr. Bhattacharya. NIH will, under his leadership, focus research on solving directly the nation's most critical health priorities, especially chronic conditions like cancer, diabetes, heart disease, and obesity.

Funding Reforms and Research Priorities

NIH has experienced deep budgetary shifts over the last few months, with grant support suspended and restored, and indirect university research costs capped prior to the intervention of a federal judge. Dr. Bhattacharya is anticipated to negotiate these budget intricacies in order to secure ongoing support for innovative scientific discoveries.

Secretary Kennedy voiced his confidence in the new director, stating, “Under Dr. Bhattacharya’s leadership, NIH will restore its commitment to gold-standard science. I’m excited to work with him to ensure NIH research aligns with our Administration’s priorities — especially tackling the chronic disease epidemic and helping to Make America Healthy Again.”

Dr. Bhattacharya has been vocal about the importance of free speech in scientific discourse. In October 2024, he tweeted on X (formerly Twitter), "If you support government regulation of disinformation, you are an enemy of free speech." Now, as NIH Director, he has directed agency personnel to prepare a list of grants and contracts focused on fighting misinformation and disinformation, a step that could be evidence of a change in how government agencies handle scientific controversy and public messaging.

Prior to coming to NIH, Dr. Bhattacharya was a tenured professor at Stanford University, where he worked on population aging and chronic diseases, especially among vulnerable populations. He co-authored the Great Barrington Declaration in the COVID-19 pandemic, calling for a focused protection strategy instead of broad lockdowns.

As he enters this critical position, Dr. Bhattacharya is charged with guiding NIH through trying times, keeping research priorities in synch with public health needs, and reaffirming the agency's commitment to scientific integrity. His tenure will begin a new era for NIH, one that holds the promise of reforms to promote innovation, accountability, and reinvigorated faith in medical research.