Medicine Redefined 177. Ketamine, Trauma, and the Future of Psychiatry | Rocky Sullivan, DO
In this episode of Medicine Redefined, Darsh and Altamash sit down with Dr. Patrick “Rocky” Sullivan, an emergency physician turned ketamine therapy pioneer, to explore how this powerful molecule is quietly transforming mental health care. Drawing from years of ER experience and clinical innovation, Dr. Sullivan breaks down the science, stigma, and promise behind ketamine treatment for depression, PTSD, addiction, and chronic pain.
We unpack the nuances of off-label prescribing, why most depression treatments miss the mark, and how ketamine-assisted psychotherapy (KAP) is helping patients rewire trauma in real time.
If you’ve ever wondered how ketamine really works, who it's for (and who it’s not), or what a responsible treatment plan should look like, this conversation will change your perspective. It's an eye-opening look into the future of mental health care.
TIMESTAMPS
00:00 Introduction to Medicine Redefined
00:36 Meet Dr. Patrick Sullivan
01:46 The Evolution of Ketamine Therapy
03:18 Rocky's Journey into Psychiatry
07:57 Understanding Ketamine's Mechanism
08:49 Off-Label Uses and Research
11:12 Ketamine in Emergency and Pain Management
14:14 The Importance of Set and Setting
15:29 From Anesthetic to Antidepressant
17:15 Mainstream Depression Treatments
23:02 Navigating Treatment Options
26:45 Screening and Safety Protocols
37:29 Ketamine Assisted Psychotherapy
41:42 Telehealth and Ketamine Delivery
42:16 The Importance of Provider Interaction
43:11 Case Studies: Depression and OCD
43:55 Case Studies: Pain and Trauma
44:24 Case Studies: Alcohol Use Disorder
46:12 The Role of Therapy in Ketamine Treatment
47:54 Ketamine's Mechanism and Benefits
52:09 Maintenance and Dosage Variability
01:05:13 Challenges in Ketamine Research and Regulation
01:16:14 Conclusion and Contact Information
SOURCES
04:13: Ketamine suicidal ideation meta-analysis; Ketamine depression meta-analysis
05:09: What is ketamine?
06:01: History of ketamine
07:36: Off-label prescriptions
07:44: Research referenced on alcoholism and ketamine:
07:44: 2000 study done on depression and ketamine
07:44: 2006 study repeated
09:30: Ketamine dose-dependent responses
10:13: Ketamine on respiratory drive
10:58: Ketamine for asthma
13:47: Psychedelic therapy
15:21: Treatment-resistant depression
16:18: SSRIs and other antidepressant drugs
17:36: ECT and Ketamine therapy studies:
18:48: TMS
18:48: Spravato study
18:48: IV Infusion ketamine study
22:19: Treatment resistance depression prevalance
25:20: Mathew Perry story
28:05: Studies on how Ketamine works in the brain:
29:30: Adjustment disorders
32:21: Studies on BDNF and ketamine:
32:37: Exercise and BDNF
32:39: HIIT and BDNF
35:08: Ketamine assisted psychotherapy research
38:08: Ketamine for PTSD
44:27: EMDR
44:46: How to change your mind:
01:04:25: Ketamine is top-studied drug in depression
01:05:40: Low-dose naltrexone
01:06:00: FDA approval for naltrexone
01:07:23: American Society of Ketamine Physicians, Psychotherapists & Practitioners
01:14:02: Rocky’s website!