“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.

In a comprehensive study spanning more than five decades, researchers have found that overall deaths due to heart disease in the United States have significantly declined since 1970.

However, the study also points to a concerning rise in mortality from specific non-ischemic heart conditions such as heart failure, hypertensive heart disease, and arrhythmias.

Published online on June 25 in the Journal of the American Heart Association, the research highlights both the gains made in managing ischemic heart disease and the urgent need to address other forms of cardiovascular illness.

66% Drop in Overall Heart Disease Mortality

The study, led by Dr. Sara J. King of Stanford University School of Medicine, analyzed data from the Centers for Disease Control and Prevention's (CDC) National Vital Statistics System. It focused on U.S. adults aged 25 and older, tracking age-adjusted heart disease mortality rates from 1970 through 2022.

The findings are significant: overall heart disease mortality dropped by 66 percent—from 761 deaths per 100,000 people in 1970 to 258 per 100,000 in 2022. This decline is largely attributed to advances in the treatment and prevention of ischemic heart disease, especially acute myocardial infarctions, commonly known as heart attacks.

The proportion of heart disease deaths attributed to ischemic heart disease also declined sharply. In 1970, ischemic conditions accounted for 91 percent of all heart disease deaths. By 2022, that number had dropped to 53 percent.

Sharp Decline in Heart Attack-Related Deaths

One of the most notable findings was the 89 percent decline in deaths due to acute myocardial infarction.

Mortality from all ischemic heart diseases decreased by 81 percent. These improvements have been credited to better public awareness, improved emergency response systems, lifestyle changes, and the development of more effective medications and medical procedures.

“This evolution over the past 50 years reflects incredible successes in the way heart attacks and other types of ischemic heart disease are managed,” said Dr. King in a statement released with the study.

Rise in Non-Ischemic Heart Conditions

However, not all trends pointed in a positive direction. The same period saw a significant increase—81 percent—in mortality from non-ischemic forms of heart disease. Most notably, the death rate from arrhythmias rose by 450 percent, while hypertensive heart disease and heart failure saw increases of 106 and 146 percent, respectively.

These figures suggest that while the fight against ischemic heart disease has made great strides, the growing burden of other cardiac conditions may require new strategies and interventions.

“The substantial increase in deaths from other types of heart conditions, including heart failure and arrhythmias, poses emerging challenges the medical community must address,” said Dr. King.

Note: The authors of the study acknowledged financial ties to the pharmaceutical industry, a standard disclosure in research of this nature.

Researchers have discovered that something as simple as weakened grip strength may be an early warning sign of psychosis—a complex mental condition marked by distorted thinking, delusions, and hallucinations. Published in the American Journal of Psychiatry, the study adds to a growing body of evidence that subtle changes in physical functioning, especially motor skills, may be deeply intertwined with brain health and psychiatric conditions.

The findings point to a potential paradigm shift in how clinicians may one day screen for psychosis—by using an everyday, easily measurable physical marker. As mental health professionals and researchers seek better ways to identify and treat psychosis before it fully develops, the humble handgrip test may soon become a vital tool in the psychiatric toolkit.

What is Psychosis?

Psychosis is a term that describes a range of symptoms where a person loses touch with reality. Classic signs include delusions (false beliefs) and hallucinations (seeing or hearing things that aren’t there). However, the journey into psychosis often begins long before these dramatic symptoms appear. Early warning signs can be subtle—changes in behavior, social withdrawal, trouble thinking clearly, or a decline in self-care.

Psychosis typically emerges in late adolescence or early adulthood, but it can affect people at any age. It’s a feature of several mental health disorders, including schizophrenia, bipolar disorder, and severe depression, and can also arise in older adults as a result of neurological conditions like Parkinson’s or Alzheimer’s disease.

The study involved 89 participants recently diagnosed with psychosis (within the past five years), compared with 51 individuals in good mental and physical health. Participants underwent grip strength tests, well-being assessments, and brain imaging scans.

Not only did those with psychosis show significantly lower grip strength, but this weakness was also tied to changes in the brain's default mode network—a complex system that becomes active during rest, daydreaming, or inward-focused thoughts. Researchers found that lower grip strength correlated with reduced connectivity in three key brain regions:

• The anterior cingulate cortex,
• The sensorimotor cortex, and
• The cerebellum.

All three play vital roles in motor function, cognition, and emotion. When connectivity among these regions decreased, so did physical grip strength and overall psychological well-being.

Why A Strong Grip Strength Important?

Grip strength has long been recognized as a general indicator of health. Lower grip strength is associated with higher mortality risk, reduced quality of life, and poorer day-to-day functioning. But its connection to mental health—and specifically to psychosis—is a new and important insight.

“Grip strength seems to capture that things are not going well, but it hasn’t been well studied in relation to brain function or early psychosis,” said Dr. Alexandra Moussa-Tooks, senior researcher and assistant professor of psychological and brain sciences at Indiana University.

The study’s findings suggest that changes in grip strength may reflect underlying disturbances in brain network function—what researchers call “resting-state functional connectivity.” In other words, the physical symptom of a weakening grip could be a visible sign of invisible changes happening in the brain.

While it may seem far-fetched to connect your ability to open a pickle jar with your mental stability, grip strength is increasingly being recognized as a proxy for overall health—both physical and cognitive. Past research has linked low grip strength to a higher risk of cardiovascular disease, frailty, depression, and even early mortality.

This new study takes it a step further by linking grip strength to resting-state functional connectivity in the brain—a measure of how different parts of the brain interact when a person is not actively doing a task. The less synchronized these connections, the more likely a person is to experience disturbances in thought, behavior, and even basic physical abilities.

Dr. Heather Burrell Ward, lead author and assistant professor of psychiatry at Vanderbilt University Medical Center, said the findings "identify potential brain targets for new treatments for psychosis," including the possibility of using magnetic brain stimulation or exercise to strengthen neural connections.

Symptoms of Psychosis

“If Psychosis Is a Fire, Symptoms Are the Smoke”

Traditionally, treatment for psychosis has focused on managing the “smoke”—the overt symptoms like delusions and hallucinations. But as Dr. Moussa-Tooks explains, “If psychosis is a house on fire, symptoms such as delusions and hallucinations are the smoke. In a fire you don’t target the smoke, you target the fire and its source. And yet, currently that’s not how we approach treatment for psychosis.”

Motor disturbances, such as reduced grip strength, may be among the earliest signs that something is amiss in the brain. Because these changes are more fundamental and easier to measure than complex cognitive symptoms, they could help clinicians identify and address psychosis at its source—potentially before full-blown symptoms develop.

What Causes Psychosis?

Psychosis is a complex condition with no single cause. It arises from a combination of genetic vulnerability, brain development differences, and environmental stressors or trauma. While it can be a symptom of mental illnesses like schizophrenia or bipolar disorder, it can also occur independently or as part of physical illnesses, particularly in older adults.

Recognizing early warning signs—whether behavioral, emotional, or physical—can make a crucial difference in outcomes. Early intervention is associated with better long-term recovery and improved quality of life.

Could a handgrip test become a new mental health screening tool? The researchers believe it's possible.

“Grip strength and other motor functions are easily assessed and more readily interpretable than complex tasks often used to study psychosis,” said Moussa-Tooks. “Our work shows that these simple metrics could have profound implications in early detection and treatment.”

Such early detection tools are especially critical, as earlier intervention in psychosis typically leads to better outcomes. The current model, which relies heavily on self-reported symptoms or behavioral changes, is reactive and often too late.

As science continues to uncover the deep connections between brain and body, one thing becomes increasingly clear—sometimes, holding on tightly might be the very first step to staying mentally well.

With rates of esophageal cancer having quadrupled since the 1970s and fewer than 20% of patients surviving five years post-diagnosis, early detection is more critical than ever. The capsule sponge test offers a powerful tool for risk stratification, ensuring that high-risk individuals continue receiving endoscopy while sparing low-risk patients from unnecessary invasive procedures.

The gold standard for monitoring patients at risk of esophageal (throat) cancer has been the endoscopy—a procedure that, while effective, is invasive, uncomfortable, and resource-intensive. Now, a simple device known as the “pill-on-a-string” or capsule sponge test is emerging as a transformative alternative, promising to make screening and surveillance for throat cancer faster, less invasive, and more accessible for millions worldwide.

The concept is ingeniously simple: patients swallow a small capsule attached to a string. Once in the stomach, the capsule dissolves, releasing a sponge that expands to about the size of a coin. Healthcare professionals then gently pull the sponge back up by the string, allowing it to collect cells from the lining of the esophagus as it travels upward. The entire procedure takes about ten minutes and can be performed by a nurse in a clinic or even a mobile screening van.

Barrett’s esophagus is a chronic condition in which prolonged acid reflux damages the lining of the esophagus. Over time, the damaged cells can become precancerous, forming dysplasia, and potentially progressing into esophageal adenocarcinoma—a type of throat cancer with notoriously poor survival rates. Despite the relatively low annual conversion rate from Barrett’s to cancer (approximately 0.5%), regular monitoring is essential.

Traditionally, endoscopy has been the go-to method for this surveillance. However, it is not without drawbacks: sedation, fasting, potential complications, and significant cost. This is where the pill-on-a-string method is poised to transform care—making monitoring more accessible, efficient, and patient-friendly.

What Is the Pill-on-a-String Test?

The new test involves swallowing a capsule containing a compressed sponge. Once it reaches the stomach, the capsule dissolves, allowing the sponge to expand. Attached to a string, the sponge is gently pulled back up through the esophagus, collecting cells from the lining along the way. These cells are then analyzed in a lab for red-flag changes indicative of dysplasia or early cancer.

Though the idea may initially sound uncomfortable, the experience has proven to be far more tolerable than an endoscopy. For Duncan Cook, a 57-year-old heating engineer from Cambridge, who has endured nearly two decades of endoscopic monitoring, the change was welcome.

“The first time I had the sponge, I was a bit nervous,” Cook shared in a news release. “It’s quite a big pill to swallow, but it’s much better than going for endoscopies... I was able to have the test done and go right back to work after.”

A major challenge is that symptoms often overlap with benign conditions like heartburn, leading to late diagnoses when treatment options are limited. Early detection is critical: when caught at stage 1, five-year survival rates can reach 63%. This is why regular surveillance of high-risk individuals—particularly those with Barrett’s esophagus—is so important.

In a large multi-center trial involving 910 patients across 13 hospitals in the U.K., researchers from the University of Cambridge and Queen Mary University of London evaluated the effectiveness of the capsule sponge test. Participants—all of whom were already being monitored for Barrett’s esophagus—underwent both the new test and a standard endoscopy for comparison. Findings from the study, recently published in The Lancet, are compelling:

• 54% of patients were classified as low-risk after the sponge test, showing no cellular changes that could indicate progression to cancer.
• Only 0.4% of the low-risk group were later found via endoscopy to have high-risk cell changes.
• No cancers were detected in those flagged as low-risk by the sponge test.

These results suggest that more than half of the patients undergoing routine endoscopies could safely switch to the capsule test without compromising diagnostic accuracy.

“Our findings suggest that the capsule sponge could help stratify patients with Barrett’s esophagus by risk,” said Dr. Peter Sasieni, director of the Cancer Research UK Cancer Prevention Trials Unit. “Given the low risk of progression in these individuals, it should be safe to replace their usual endoscopy with the capsule sponge.”

The research team isn’t stopping here. Scientists are now working to refine the sponge test further by enhancing laboratory analysis of the collected cell samples. Artificial intelligence (AI) is being evaluated to assist in identifying early signs of dysplasia, potentially boosting accuracy and reducing human error.

Professor Rebecca Fitzgerald, director of the Early Cancer Institute at Cambridge, noted, “We need an alternative surveillance method that’s less invasive, easier to administer and more reliable… Endoscopies aren’t always a reliable way of spotting early cancers, and they depend on the skill of the person doing it."