“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 President of the United States, Donald Trump, has revealed that he takes aspirin every day, sharing that he has been doing so for decades because he believes it helps keep his blood “thin”.

He said it while discussing his aspirin use and the bruising that was recently seen on his knuckles. He also said that doctors have advised he take a lower dose.

“I take an aspirin a day. I don’t know if it works but psychologically I need it. It thins the hell out of your blood I guess. I don’t know if it works or not but I’ve been doing it for a long time. And here I am making speeches. I like Bayer aspirin. And I take the big one. They want me to go down to the 80. I take the 386. I don’t know what the hell it is. It’s a monster. They said, ‘Sir, you don’t need that!’ I said, do me a favor, I’ve been doing okay for 35 years. Leave me alone.”

So, does taking an aspirin every day actually protect the heart? And if yes, does a higher dose necessarily provide better results?

Aspirin Reduces Blood Clot Formation

Aspirin affects platelets, which are tiny components of blood that help form clots. By making platelets less likely to clump together, aspirin can reduce the formation of blood clots that could block an artery supplying the heart or brain.

This is why doctors may prescribe daily aspirin to people who have already had a heart attack, stroke, or procedures like coronary stent placement.

But aspirin does not make the blood “thin” in a literal sense. It changes the way blood platelets clot. The US Food and Drug Administration (FDA) says daily aspirin can help people with cardiovascular disease or those who have already had a heart attack or stroke, but daily use is not suitable for everyone.

Aspirin can reduce the risk of certain blood clot formations, but it can also increase the risk of unwanted bleeding. The FDA warns that aspirin can lead to serious side effects like bleeding in the stomach and brain.

It recommends that people do not take daily aspirin without discussing it first with their healthcare professionals.

Mayo Clinic also says that daily aspirin is not right for everyone. Regular use can increase the risk of gastrointestinal bleeding and stomach ulcers, while in some people it can also increase the risk of a bleeding stroke.

Also read: Trump Administration Asks SC To Restrict Gender-Affirming Care In Prisons: What Happens If Treatment Stops

Who Should And Shouldn't Take It?

For people who have never had a heart attack or stroke or any other type of cardiovascular disease, taking aspirin routinely to prevent a cardiovascular event is generally not recommended.

The American Heart Association says routine daily aspirin is not recommended for most healthy adults without cardiovascular disease because its benefit can be offset by the risk of serious bleeding.

The FDA also says that for people without cardiovascular disease risk, the risks of long-term aspirin use may be greater than the benefits.

For someone who has already had a heart attack, stroke or any other cardiovascular event, doctors may prescribe daily aspirin because preventing another clot-related event can outweigh the bleeding risk.

According to Mayo Clinic, this is a secondary method of prevention. It says that the benefit of daily aspirin in this group is well established. This does not mean that patients should start, stop or change their aspirin dose on their own.

Also read: White House Chief Of Staff Susie Wiles Reveals Brutal Toll Of Fighting Cancer

Is A Bigger Aspirin Dose Better For Heart?

A higher dose does not automatically provide better protection against heart attacks. Low-dose aspirin prescribed for cardiovascular health is usually around 75 to 100 mg, with 81 mg frequently used.

Mayo Clinic says that the appropriate dose depends on the individual and should be discussed with a healthcare professional.

Taking higher doses of aspirin can increase the risk of bleeding. People with a history of stomach ulcers or gastrointestinal bleeding, bleeding disorders or aspirin allergy may also face greater risks.

The risk of bleeding also increases with age. The American Heart Association says routine aspirin for primary prevention is generally not recommended for healthy adults over 70.

According to the World Health Organisation, the global life expectancy has recovered to almost pre-pandemic levels, a significant public achievement, but the world is facing a growing burden from chronic diseases,

WHO's latest health estimates, which released recently, offer a glimpse into the pattern of life expectancy and disease burden between 2000 and 2023. It also says that while damages due to COVID-19 have been reversed, the world is grappling with a growing burden of noncommunicable diseases (NCDs).

Global Life Expectancy Is Almost Back To 2019 Levels

Global life expectancy reached 73.3 years in 2023, compared to 73.4 years in 2019, just before the COVID-19 pandemic hit. However, the pace at which healthy life expectancy has recovered has been slow and steady. It stood at 62.8 years in 2023, which was still 0.4 years below the 2019 level.

This means people are living almost as long as they were before the pandemic, but the number of years they can expect to live in good health has not fully recovered.

Dr Alain Labrique, Director of WHO’s Department of Data, Digital Health, Analytics and AI said, "Living longer is one of the great achievements of public health. The next challenge is to ensure that those additional years are lived in good health, while health systems are equipped to respond to the changing needs of populations."

Also read: 100% Blockage At 18, 25% Patients Under 40: On World Heart Day, Cardiologists Reveal An Alarming Heart Attack Pattern

NCDs Account For 74% Of Global Deaths

The WHO data also depicted a growing share of deaths caused by NCDs. In 2023, NCDs accounted for 74% of all deaths globally, compared to 58% in 2000.

In fact, eight of the world's 10 leading causes of death were NCDs in 2023. These include cardiovascular diseases, cancer, diabetes and chronic respiratory diseases.

The change is not limited to wealthier countries. The shift in NCD-related deaths was visible across all income levels.

In 2023, for the first time, communicable diseases accounted for less than half of all deaths in low-income countries, showing how disease patterns are changing even in populations that have traditionally carried a higher burden of infectious diseases.

Also read: Japan Has 107,677 Centenarians; 88% Are Women: Challenges Of An Aging Population

Heart Disease Remains The World's Biggest Killer

Cardiovascular disease continues to be the leading cause of death worldwide. Ischaemic heart disease alone caused about 9.5 million deaths in 2023, along with an estimated 210 million disability-adjusted life years, a measure that combines years lost because of premature death and years lived with disability.

While there has been progress in reducing the burden of ischaemic heart disease in many parts of the world since 2000, the WHO noted increases in individual-level cardiovascular risk in the South-East Asia and Western Pacific regions.

This highlights continuing differences in cardiovascular health between populations.

Also read: Blue Zones Diets: What the World’s Longest-Livers Eat

Diabetes And Dementia Also Among Major Contributors

The WHO estimates point to growing concerns around other chronic conditions like diabetes and dementia. The risk of dying from diabetes has increased substantially since 2000, especially in South-East Asia.

Dementia has also landed among major causes of death globally. Alzheimer disease and other dementias became the fifth leading cause of death worldwide in 2023, compared to 19th in 2000. Global deaths from dementia tripled between 2000 and 2023, according to the WHO.

Mental Health Adds To The Burden

Between 2019 and 2023, the global age-standardised DALY (disability-adjusted life year) rate increased by approximately 20% for depressive disorders and nearly 45% for anxiety disorders. Together, these conditions were responsible for an estimated 110 million years of healthy life lost through premature death and disability in 2023.

Drug use disorders have also been observed across different trends across regions. Between 2000 and 2023, the WHO Region of the Americas recorded the largest increases in the risk of death linked to these disorders, while the Western Pacific region saw declines.

In a nutshell, the world has largely recovered the ground lost in overall life expectancy during the pandemic. But simply living longer does not necessarily mean we are living healthier. As populations age and infectious diseases account for a smaller share of deaths in many regions, health systems are increasingly required to manage conditions that often need long-term prevention, diagnosis, treatment and care.

“The value of these estimates is not only in the numbers themselves,” said Dr Labrique. “By showing how causes of death and disease burden are changing over time and across populations, they give countries evidence to help shape health policies and priorities.”

“These capabilities are critical to better enable targeted, effective interventions and ultimately further improving health and well-being for all.”

The US Food and Drug Administration (FDA) has approved pirtobrutinib as a first-line treatment for adults with previously untreated chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL) who do not have a known deletion of chromosome 17p.

The approval expands the use of the targeted cancer drug, which was previously approved for certain patients whose CLL or SLL had returned or stopped responding to earlier treatment. It is developed by Eli Lilly and Company and will be sold under the brand name Jaypirca.

More About Pirtobrutinib

CLL is a type of blood cancer in which the bone marrow produces too many abnormal B lymphocytes, a type of white blood cell. These abnormal cells can build up in the blood, bone marrow and lymph nodes.

SLL is closely associated with CLL, but the cancer cells are found mainly in the lymph nodes. CLL can progress slowly in some people, while others may develop more aggressive disease.

Pirtobrutinib is a Bruton tyrosine kinase (BTK) inhibitor, a type of targeted therapy. BTK is a protein that helps B cells receive signals needed for their growth and survival. By blocking BTK, pirtobrutinib interferes with signals that cancerous B cells depend on.

Unlike older covalent BTK inhibitors, pirtobrutinib is a non-covalent, reversible BTK inhibitor, meaning it binds to BTK differently.

A dose of 200 mg once a day is recommended for newly diagnosed patients covered by this approval. It should be taken until the cancer progresses or side effects become severe.

Also read: 2 Indians Charged In US Over Fake Ozempic Scheme: How To Spot Counterfeit GLP-1 Drugs

Findings From Pirtobrutinib's Trial

The FDA based its decision on the BRUIN CLL-313 trial, which included 282 adults with previously untreated CLL or SLL without a 17p deletion.

Participants were randomly assigned to receive either pirtobrutinib or the chemotherapy combination bendamustine plus rituximab.

After a median follow-up of 28 months, the median progression-free survival could not yet be calculated for patients receiving pirtobrutinib because enough disease-progressing events had not occurred. In the bendamustine-rituximab group, median progression-free survival was 33.5 months.

The risk of disease progression or death was 80% lower with pirtobrutinib than with bendamustine plus rituximab in the trial, based on the reported hazard ratio of 0.20.

However, overall survival data are still not 100% reliable. There were 13 deaths at the time of the primary analysis - three in the pirtobrutinib group and 10 in the comparison group.

Also read: 21% In 80 Weeks: Lancet Study Finds Lilly’s Retatrutide Delivers One Of The Biggest Weight Losses Ever

Pirtobrutinib's Side Effects

The most common non-laboratory side effects reported with pirtobrutinib included:

• Upper respiratory tract infections
• Rash
• COVID-19

According to the FDA, side effects also include infections, bleeding, reduced blood cell counts, abnormal heart rhythms, other cancers, liver toxicity and harm to an unborn baby. Serious adverse reactions occurred in 28% of patients receiving pirtobrutinib in the trial.

The approval gives eligible people with previously untreated CLL or SLL another targeted treatment option that can be taken as a daily oral medicine.

Jennifer A. Woyach, MD, director of the Division of Hematology at The Ohio State University Comprehensive Cancer Center, said, “This approval is grounded in data from BRUIN CLL-313, which showed a significant delay in disease progression for pirtobrutinib compared to chemoimmunotherapy, along with safety and tolerability consistent with its established profile.”

The FDA's decision applies specifically to adults with previously untreated CLL or SLL without a known 17p deletion. It therefore does not mean that pirtobrutinib is automatically the first treatment for every person newly diagnosed with CLL.