June 23, 2025

177. Ketamine, Trauma, and the Future of Psychiatry | Rocky Sullivan, DO

177. Ketamine, Trauma, and the Future of Psychiatry | Rocky Sullivan, DO
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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!