“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.

Hundreds of GLP-1 users in the US are suing drugmakers Novo Nordisk and Eli Lilly, alleging they developed a rare form of sudden vision loss called nonarteritic anterior ischemic optic neuropathy (NAION) after taking drugs such as Ozempic, Wegovy and Mounjaro.

The lawsuits allege the companies failed to adequately warn patients about the potential risk, that is often irreversible.

What Is The Controversy?

US law firm Weitz & Luxenberg has filed more than 90 lawsuits in New Jersey state court since 2025 on behalf of people who say they developed NAION while taking Ozempic or Wegovy, according to The Wall Street Journal.

Separate federal lawsuits in Philadelphia accuse Novo Nordisk and Eli Lilly of failing to provide adequate warnings about the potential eye-related risk. The cases are pending.

Regulators in Europe and Australia have required warnings about a possible increased risk of NAION with some GLP-1 medicines after reviewing available evidence.

In the US, vision problems are listed as possible side effects, but the FDA does not currently require NAION to be listed as a specific risk. The FDA's Sentinel Initiative is reviewing the possible safety signal linking GLP-1 drugs to NAION.

"The FDA routinely monitors the safety of drug products post-marketing. The FDA identifies safety signals from a variety of sources, evaluates the available data and takes regulatory actions when appropriate,” an FDA spokesperson said, according to ABC News.

Also read: Ozempic, Wegovy, Mounjaro and Zepbound May Fuel Rare Brain Disorder, Study Finds

What Do The Drugmakers Say?

Novo Nordisk, which makes Ozempic and Wegovy, said it takes “all reports of adverse events very seriously” but called the personal injury lawsuits "without merit."

The company said it is "committed to patient safety and continuously monitors the safety profile of our GLP-1 RA products." It added that if "emerging safety data warrant further action, appropriate measures will be implemented".

Lilly, which makes Zepbound and Mounjaro, said patient safety is its "top priority."

"We actively monitor, evaluate, and report safety information for all our medicines to the FDA," the company said, adding that it continues to review data on potential ophthalmic issues.

What Does The Science Say?

The evidence linking GLP-1 drugs to NAION remains mixed. Some observational studies have found an association, while others have not. Researchers have not established that GLP-1 drugs cause NAION.

What Studies Have Found

• 2025 JAMA study: Among more than 159,000 people with type 2 diabetes, 35 GLP-1 users developed NAION versus 19 in the comparison group. Researchers also found an increased risk of other optic nerve disorders in 93 patients.
• Another 2025 JAMA study: Found no statistically significant association between GLP-1 use and NAION, although it reported a slight increase in diabetic retinopathy.
• 2026 safety analysis: A British Journal of Ophthalmology analysis of more than 30 million FDA adverse-event reports from 2017 to 2024 identified a safety signal linking semaglutide medicines to NAION.
• Wegovy vs Ozempic: The signal was nearly five times stronger for Wegovy than Ozempic, although both contain semaglutide.

The North American Neuro-Ophthalmology Society and American Academy of Ophthalmology said studies have produced mixed results.

"While many report a small possible increased risk of NAION in patients taking GLP-1 RAs such as semaglutide, some studies report no correlation, and the overall magnitude of the risk of NAION remains low,” the groups said.

Read More: Exclusive: GLP-1 Drugs Are The ‘New Statins’, Says University Hospital Birmingham Professor

What Is NAION?

NAION is the most common acute optic neuropathy in people over 50, according to Mayo Clinic. It occurs when blood flow to the optic nerve is suddenly reduced, damaging the nerve that carries visual information from the eye to the brain.

It typically causes painless vision loss in one eye.

Some patients experience partial improvement, but vision loss is often permanent. There is currently no proven treatment to reverse the damage.

Diabetes itself can increase the risk of NAION, regardless of GLP-1 use. Other risk factors include overnight low blood pressure and having a very small optic nerve cup.

The US Food and Drug Administration (FDA) has a step towards reducing animal use in drug research, focusing on technologies like human organoids, organs-on-chips, artificial intelligence and computer modelling that may play a bigger role in deciding whether medicines are safe before they are tested in people.

The move is part of the US Department of Health and Human Services's initiative declared on September 21 to shift biomedical research towards methods that reflect human biology more closely.

As part of the changes, the FDA issued a rule updating its regulations to state that non-animal methods can be used where it is appropriate to assess the safety of drugs before human trials.

“This new rule supports the Trump Administration’s push to explore ways to complement, or where appropriate, replace animal studies with methods that may better predict how medicines will actually affect people,” FDA Acting Commissioner Kyle Diamantas said.

“Our goal is not to replace one rigid approach with another. It is to support rigorous, modern science — including animal studies when they remain appropriate and validated alternatives when they can provide the evidence needed to protect patients,” he added.

Why Is FDA Moving Away From Animal-Based Studies?

Animal testing has always been a central part of drug development for decades. But a drug behaving safely in an animal does not necessarily mean it will behave the same way in humans. This is partly because species differ in their biology, metabolism and immune responses.

The FDA's new approach is built around New Approach Methodologies (NAMs), a term for covering laboratory and computational methods that can provide more accurate evidence without relying entirely on animals.

The agency has already issued guidance on how developers can use and validate these methods. It has also created a database containing examples of NAMs used in FDA reviews.

Also read: HHS Announces US FDA’s First AI Chief: Here’s What It Means For The Future Of Drug Regulation

Organoids May Replace Some Animal Experiments

Organoids are three-dimensional clusters of cells grown from human stem cells. They can replicate the structure and some of the function of organs.

Researchers can grow models resembling parts of the liver, intestine, brain, kidney or other tissues and use them to test experimental medicines. This can allow scientists to study how human cells respond directly to a drug, including side effects.

The HHS initiative includes plans for the NIH Clinical Center to develop a laboratory combining standardised human organoids with robotics, AI and advanced data systems.

Also read: Donald Trump Wants Childhood Vaccines Split Into 5 Shots To Prevent Autism: But Is There Evidence?

What Are Organs-On-Chips?

Organs-on-chips, also called microphysiological systems, are small devices containing human cells that mimic aspects of an organ's structure and environment. Researchers can expose these cells to drugs and observe their responses in a controlled environment.

For example, a liver-on-a-chip can help researchers investigate whether a drug damages liver cells, while other systems can model the interaction between different tissues.

The FDA says newer approaches include human cells, organs-on-chips and computer models, provided they are appropriately suitable scientifically.

Also read: Pennsylvania Measles Outbreak Crosses 700 Cases As State Seeks CDC Help

AI & Computational Models

AI and computational models can analyse huge amounts of biological and drug data to predict how a medicine may behave in the human body.

HHS' Advanced Research Projects Agency for Health is investing in computational approaches designed to assess drug safety and reduce dependence on animal experiments.

The FDA's rule, however, does not prohibit animal studies. Instead, it does away with language that imply animal testing is the only acceptable way to test drugs and biomedical products.

Non-animal studues can be used when they are scientifically appropriate for the particular drug and regulatory requirements.

Low levels of vitamin D during pregnancy could be linked with a higher risk of preterm birth. The strongest link were seen among women who delivered very prematurely, according to a recent study.

Researchers from the Medical University of South Carolina studied health data from 15,506 pregnancies in which the vitamin D levels of expectant mothers measured during pregnancy.

The study, published in the Journal of Perinatology, found that women with lower levels of 25-hydroxyvitamin D, the main blood marker used to assess vitamin D status, were more likely to deliver before 37 weeks.

The association was even more pronounced among women who delivered before 32 weeks, a group which is considered very preterm.

What Did The Study Find?

Of the 15,506 deliveries, 13,451 were at term, while 1,652 were moderately preterm and 385 occurred before 32 weeks. The researchers found that women who delivered preterm had lower average vitamin D concentrations than those who delivered at term. The lowest vitamin D levels were seen among women who delivered before 32 weeks.

Nearly 45% of women had a vitamin D level below 30 ng/mL at some point during pregnancy, while about 66% had levels below 40 ng/mL.

The researchers adjusted their analysis for maternal age, race and ethnicity and insurance status, and the association between higher vitamin D levels and lower odds of preterm birth remained same.

But, this was a retrospective observational study, meaning it can identify an association but cannot prove that low vitamin D itself caused an early delivery. Other factors that influence both vitamin D levels and pregnancy outcomes may also play a role.

Also read: Ferritin Face: Can Pale Skin Signal Iron Deficiency?

Vitamin D And Pregnancy

Vitamin D is best known for its role in calcium absorption and bone health, but it also plays a role in immune function, placental development and other processes involved in pregnancy.

Researchers say several biological mechanisms could potentially explain the association with preterm birth, including effects on inflammatory pathways, placental function and fetal growth.

The findings also add to previous research. A 2025 NIH-funded study involving 351 first-time mothers found that women with vitamin D levels below 40 nmol/L during the first trimester had 4.35 times the risk of preterm birth compared with women whose levels were above 80 nmol/L.

Another import aspect is that the new study shows that lower vitamin D levels are associated with earlier delivery, but it does not show that raising vitamin D levels will prevent preterm birth.

A Cochrane review found the evidence for vitamin D supplements reducing preterm birth is not certain or confirmed. The NIH's current guidance notes also state that there is insufficient evidence to recommend routine vitamin D supplementation specifically to prevent preterm birth.

The researchers say randomised clinical trials are needed to determine whether optimising vitamin D levels during pregnancy can actually reduce the risk of preterm birth.