“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.

India's neighbor in the east, Bangladesh, is facing the worst of a crisis in the form of a massive measles outbreak. As per media reports, measles in Bangladesh has taken 545 lives. Facing this growing challenge, the authorities are in complete disarray.

The nation has been struggling with the disease almost from the beginning of the year, but as of now, the situation has worsened and appears as one of the worst outbreaks of measles since the inception of the country in 1971.

According to the local media, the country has a total of 458 suspected deaths and 87 confirmed deaths linked to measles since mid-March of this year. On the other hand, Bangladesh has seen 64,940 suspected measles cases and 8,719 confirmed infections in the same period.

The Directorate General of Health Services (DGHS) of Bangladesh has said that since the 15th of March, the number of admitted patients with measles was 51,585. This information was directly released by the Health Emergency Operations Center and Control Room, which is under the authority of DGHS.

Why The Measles Cases Are On The Rise In Bangladesh?

The United Nations Children’s Fund (UNICEF) said that gaps in immunization worsened during and after the 2024 student-led uprising that toppled the government, leaving large numbers of children unprotected. UNICEF emphasized the need to boost vaccination programmes and provide more funding for health facilities in the future.

Why The Situation Can Go South From Here?

Bakrid or Eid al-Adha is an occasion that is widely celebrated in Bangladesh. This Eid usually sees massive gatherings and festivities. As measles is a highly contagious disease, the chances of spreading the disease during the festivities are very likely. The public health experts and doctors are warning against attending mass gatherings. Other than that, usual long-distance travel and family visits during Eid holidays could spread the disease at an exorbitant pace.

What Is Measles?

Measles is a highly contagious virus that spreads through direct contact or through the air when an infected person coughs or sneezes. It is a vaccine-preventable disease that can cause devastating complications, including blindness, pneumonia, encephalitis, and long-term immune dysfunction.

Symptoms usually appear in 7 to 14 days after exposure and may include:

• high fever,
• cough,
• runny nose,
• red eyes,
• rashes across the body.

How To Stay Safe From Measles?

• Maintaining good hygiene, such as frequent handwashing and covering the mouth while coughing or sneezing, helps reduce transmission.

• Avoiding close contact with infected individuals and ensuring proper nutrition to boost immunity are also important.

• Public awareness and community health programs play a crucial role in prevention.

When it comes to weight loss, many try their own ways to drop the extra kilos. While portion control is advised, there are many who turn to starvation just to drop the extra kilos. In 2016, Japanese scientist Yoshinori Ohsumi won the Nobel Prize for his findings on autophagy. These findings facilitated a better understanding of conditions like dementia and Parkinson's disease. Autophagy refers to natural regeneration, which occurs at a cellular level. It reduces the chances of contracting diseases while also increasing lifespan.

Since then, drugmakers have been working towards coming up with a drug that can stimulate the process; wellness and diet experts have been willing to find a way to naturally induce the process by restricting carbs, fasting, and engaging in high-intensity exercise.

What do scientists have to say?

Experiments were also conducted on mice, and it was found that the ones who were put on genetic tools, fasting, or drugs had a tendency to live longer and remain in better overall shape. However, it is still unclear how the same effect can be replicated in humans. In mice, for instance, the effects of fasting on the brain are evident within 24 hours. In other body parts, such as the liver, the effects occur more quickly. Despite knowing that fasting is good for health, experts are unsure about the ideal duration of fasting for maximum health benefits. Researchers say that fasting does not induce autophagy, but it does have other health benefits.

What is autophagy?

Autophagy is derived from "self" and "phagein," which means "to eat." The process involves cells degrading and recycling their components. It provides fuel for energy and building blocks for cell renewal. Post-infection, it can destroy viruses and bacteria. Cells use the process to get rid of damaged organelles and proteins, and it helps counteract the adverse effects of ageing.

Autophagy was discovered in the 1960s, but its importance was recognised after Yoshinori Ohsumi's research. Researchers said that what they discovered protected against diseases like Huntington's, Parkinson's, and some forms of dementia. It also seemed beneficial in the context of infection control, along with protecting against excessive inflammation. New lifestyle books now suggest that the process can be switched on by making changes to diet and lifestyle or by observing a fast.

The impact on muscle mass

A book titled Glow 15 by Naomi Whittel shares a 15-day programme including 16-hour fasts three times a week. It shares a plan that reduces protein intake on some days, involves eating carbs later, and combines all this with high-intensity exercise. In the basic tests themselves, volunteers at Jacksonville University in Florida experienced several health benefits. Some of the participants lost about 3.5 kilos in 15 days. Others saw improvements in lean muscle mass, blood pressure, and a reduction in fine lines. Researchers said that none of these changes could cause harm to health.

Is fasting safe for all?

Researchers note that fasting too much is not a good idea for anyone. Before making drastic or major changes to lifestyle or diet, it is advised to check with a doctor first. Experts look at autophagy with optimism, and studies show that proteins together form clumps in the nerve cells of Alzheimer's and Parkinson's patients.

Amid the rising concern over GLP drugs and their rampant misuse, India is set to tighten regulations around them.

The government is also trying to find out the potential side effects of using the drug. The authorities have instructed the citizens, especially the consumers and medical professionals, to report if they observe any negative reaction with the usage of any GLP-1 drugs, including semaglutide.

In India, there is a strict policy regarding drug standards. The Indian Pharmacopoeia Commission (IPC), an apex body under the health and family welfare ministry, is the organization that regulates drug standards.

Recently, the IPC issued a public notice for observing the safety of glucagon-like peptide-1 (GLP-1) drugs, including popular semaglutide, dulaglutide, liraglutide, and tirzepatide, the Mint reported.

Notably, Indian regulatory authorities, including the health ministry, the IPC, and the Central Drugs Standard Control Organisation (CDSCO), are making enormous efforts to monitor the potential risks of these weight loss medications.

As part of this, the IPC and other bodies are calling for post-marketing surveillance to ensure patient health, identify any previously undocumented side effects, and create a safety net for the citizens.

According to the Mint report, the IPC said in the document, “Apart from semaglutide, any adverse event caused by other GLP-1 receptor agonists (such as dulaglutide, liraglutide, tirzepatide) should also be reported to the PvPI – Pharmacovigilance Programme of India.”

The patients, consumers, and medical professionals can report adverse events (AE) and adverse drug reactions (ADRs) to ARD monitoring centres.

In addition, ADR forms are also available on the IPC website, and there is a toll-free number of 1800-180-3024. The mobile app ADR PvPI 2.0 is easily available on the Google Play Store and the ADRMS software.

Also Read: GLP-1 Drugs: Why India Needs Stricter Rules Now

What is the GLP-1 Drug Mainly Used For?

The GLP-1 drugs are a popular genre of medication that mimics the original GLP-1 hormone in the human body and is responsible for controlling blood sugar, slowing digestion, and increasing feelings of fullness. Several big names fall under the GLP-1 drug category, like semaglutide, dulaglutide, liraglutide, and tirzepatide.

What Are The Side Effects Of GLP-1 Drug?

There are several possible side effects related to the use of the GLP-1 drug:

• One of the most common side effects is vomiting and nausea.
• This medication can also cause general digestive disruption, thus causing diarrhoea or constipation.
• Some other possible side effects include fatigue, headaches, abdominal pain, bloating, and decreased appetite.
• In some rare cases, gastroparesis, pancreatitis, and thyroid C-cell tumors.