Ryan S. Sultan, MD

New Grants & Applications (2025-2026)

Bender-Fishbein Endowment Award

Title: Bender-Fishbein Endowment Application
Applicant: Ryan S. Sultan, MD
Institution: Columbia University Irving Medical Center / New York State Psychiatric Institute
Status: Application submitted (January 2026)

Purpose: The Bender-Fishbein Endowment supports faculty research in the Department of Psychiatry at Columbia University. Dr. Sultan's application focuses on advancing mental health informatics research, including the application of computational methods to large-scale clinical datasets for improving understanding of ADHD treatment patterns, substance use risk, and youth mental health outcomes.

Research Focus: Continued development of the Sultan Lab's research program in psychopharmacoepidemiology, NLP-based clinical informatics, and cannabis safety research, building on the lab's existing NIDA K12-funded work and extending into new analyses of electronic health record data.

Lambert Professorship Application

Title: Lambert Professorship Application
Applicant: Ryan S. Sultan, MD
Institution: Columbia University Irving Medical Center
Status: Application submitted (January 2026)

Purpose: The Lambert Professorship is a competitive endowed position within the Department of Psychiatry at Columbia University. Dr. Sultan's application outlines his research trajectory from early career NIH-funded work on ADHD prescribing patterns through his current portfolio of cannabis safety research, digital therapeutics development, and mental health informatics.

Key Achievements Cited:

• 411+ citations on landmark JAMA Network Open 2019 study on antipsychotic prescribing in ADHD youth
• $670K+ in active NIH/NIDA funding
• Multi-Principal Investigator on the PAWS digital therapeutic for cannabis use disorder
• Director of the Sultan Lab for Mental Health Informatics
• CASNY cannabis access and safety study with FDA presentation
• 234 media mentions and 19 podcast appearances

IRB 2026: NLP Electronic Health Record Study

Title: Using Natural Language Processing (NLP) to Identify Substance Use in Attention-Deficit/Hyperactivity Disorder (ADHD)
Principal Investigator (Columbia IRB): Xuhai "Orson" Xu, PhD
Co-Investigators: Frances Levin, MD; Emma Macmanus; Steven Liao
Sultan Lab Role: Dr. Sultan participates through separate NYSPI IRB governance for downstream statistical analysis
Status: IRB submission active (2026)

Study Overview: This retrospective cohort study uses electronic health record data from Columbia-affiliated NewYork-Presbyterian facilities to evaluate substance use patterns across the lifespan among individuals with documented ADHD. The study applies Natural Language Processing models to extract substance-use-related information from unstructured, narrative clinical notes -- the free-text progress notes, psychiatric evaluations, and discharge summaries written by clinicians during patient encounters.

Specific Aims:

• Aim 1: Use NLP methods to identify and characterize substance use documentation and risk indicators within unstructured EHR text
• Aim 2: Quantify mental health-associated risk of substance use across age groups (preschool through older adults)
• Aim 3: Identify clinical and demographic predictors of substance use and examine whether consistent stimulant treatment is associated with decreased substance use risk among individuals with ADHD

Methodology:

• Retrospective cohort design with ADHD cohort (ICD-9/10 documented) and comparison cohort (non-ADHD mental health conditions)
• NLP approaches including rule-based methods (MedLEE) and large language models via HIPAA-compliant APIs
• Statistical methods: propensity score matching, survival analysis
• Data stored in HIPAA-certified NYSPI research computing environment
• Waiver of informed consent justified by retrospective nature and minimal risk

Data Source: Electronic health record data from Columbia-affiliated NewYork-Presbyterian clinical sites via NYP/TRAC (DISCOVERY) system, including structured fields (diagnosis codes, medication lists, problem lists) and unstructured clinical notes (progress notes, psychiatric evaluations, therapy notes, ED notes, discharge summaries).

Connection to Sultan Lab Research: This study complements the MarketScan ADHD Females Study by providing clinical depth through NLP extraction of information from narrative notes -- details about substance use patterns, psychosocial context, and treatment responses that do not appear in insurance claims data. Together, these complementary approaches provide both population-level breadth and clinical detail.

Columbia Endowment Application

Title: Endowment Application Combined
Applicant: Ryan S. Sultan, MD
Institution: Columbia University Irving Medical Center
Date: January 2026
Status: Submitted

Purpose: Combined endowment application supporting the ongoing research activities of the Sultan Lab, including faculty research time, research assistant support, and data access for continued analyses of ADHD treatment patterns and cannabis safety research.

Cannabis Use and New-Onset Psychosis

Title: Cannabis Use and New-Onset Psychosis: Research Background and Aims
Principal Investigator: Ryan S. Sultan, MD
Funding: $335,500
Period: 2025-2026
Type: Pharmacoepidemiological Study

1. Background and Significance

Epidemiological Evidence: Cannabis use has long been linked to psychosis in epidemiological studies. Chronic or heavy cannabis use correlates with a higher likelihood of developing psychotic symptoms, a concern relevant due to the 2x increase of adult cannabis use between 2001-2002 and 2012-2013 in the US. Notably, cannabis can induce transient psychotic-like experiences even in otherwise healthy individuals -- roughly 1 in 200 people who use cannabis may experience short-lived psychotic symptoms.

Dose-Response Relationship: There is evidence of a dose-response relationship: more frequent cannabis use (e.g. weekly or daily) is associated with increased risk of psychosis. A meta-analysis estimated that approximately one-third (33.7%) of individuals experience cannabis use at the onset of a first psychotic episode, highlighting how common cannabis exposure is among new psychosis cases.

Key Finding - European Multi-Site Study: In a large multi-site European study, daily cannabis use was reported by 29.5% of patients with first-episode psychosis (versus only 6.8% of controls). After adjusting for other factors: Daily cannabis users had ~3x higher odds of developing a psychotic disorder compared to never-users. Daily use of high-potency cannabis (high THC content) was associated with ~5x higher odds.

Biological Mechanisms: Cannabis is believed to interact with the dopamine system in the brain -- a key pathway implicated in psychosis. Recent neuroimaging evidence shows midbrain dopamine alterations (substantia-nigra/ventral tegmental area), mirroring the dopamine signaling abnormalities seen in people with untreated psychosis.

Critical Period - Adolescent Exposure: Initiating cannabis use during adolescence (while the brain is still developing) has been linked to lasting changes in brain structure and higher psychosis risk in adulthood. Frequent high-THC exposure has been associated with earlier onset of psychotic disorder.

2. Research Aims and Hypotheses

Overall Objective: To determine the association between clinically documented cannabis use and incident psychotic disorder, and to test modification of this association by state cannabis legalization contexts.

Aim 1: Association Between Cannabis Use and Incident Psychosis

Hypothesis: Individuals with a record of cannabis use will have an elevated risk of a subsequent psychotic disorder diagnosis 12 months after a CUD diagnosis compared to those with no cannabis use record.

Methodology: Identify cohort with evidence of cannabis use (ICD codes F12.x), comparison group without cannabis codes, focus on NEW episodes of cannabis use, ensure no prior history of psychotic disorder, follow forward in time for onset of psychotic disorder.

Aim 2: Impact of Cannabis Legalization Context on Psychosis Risk

Hypothesis: States or time periods with more permissive cannabis laws will exhibit higher rates of cannabis-associated psychosis.

Methodology: Stratify analyses by state and time period according to legalization status. Difference-in-differences analysis exploiting staggered timing of legalization.

3. Data Source and Analytical Approach

Data Source: Large-scale de-identified healthcare database (IBM MarketScan Commercial Claims and Encounters or similar). Contains medical and pharmacy claims for millions of insured individuals across the U.S.

Timeframe: Approximately 2010-2025

4. Expected Outcomes and Implications

Scientific Impact: Quantify risk of psychotic illness attributable to cannabis use in large U.S. cohort, provide estimate of public health burden, shed light on whether cannabis legalization influences mental health outcomes at population level.

Policy Implications: If higher psychosis incidence is found in permissive environments, policymakers should approach legalization with caution, implement safeguards: potency limits, youth access restrictions, public health campaigns.

Additional Active Grants

Columbia University Research Stabilization Fund
Amount: $100,000 | Date: June 2025 | Role: Principal Investigator

Completed Research Grants

AACAP Pilot Research Award: Antipsychotic Medications in the Treatment of ADHD
Amount: $26,145 | Period: June 2017 - November 2019 | Role: Principal Investigator
Institution: Columbia University Department of Psychiatry / New York State Psychiatric Institute

Project Summary: This AACAP-funded pilot study examined antipsychotic prescribing patterns among youth with newly diagnosed ADHD. Using the MarketScan Commercial Database (2010-2015), the study analyzed 187,563 youth ages 3-24 with new ADHD diagnoses to determine the percentage prescribed antipsychotics and identify associated clinical and demographic factors.

Key Findings:

• 2.6% (n=4,342) of youth with new ADHD diagnosis were prescribed an antipsychotic in the first year
• Only 52.7% of antipsychotic-treated youth had an FDA-approved or evidence-supported indication for antipsychotic use
• Less than half (47.9%) received stimulant medication before initiating antipsychotic treatment
• Antipsychotic use strongly associated with psychiatric comorbidity:
  • Self-harm/suicidal ideation (aOR 7.5, 95% CI 5.9-9.6)
  • Oppositional defiant disorder (aOR 4.4, 95% CI 3.9-4.9)
  • Substance use disorder (aOR 4.0, 95% CI 3.6-4.5)
  • Inpatient treatment (aOR 7.9, 95% CI 6.7-9.3)

Published Research: Sultan RS, Wang S, Crystal S, Olfson M. Antipsychotic Treatment Among Youths With Attention-Deficit/Hyperactivity Disorder. JAMA Network Open. 2019;2(7):e197850.

Conference Presentations:

• Sultan RS, Olfson M. Cohort Analysis of Antipsychotic Treatment in ADHD. AACAP Annual Meeting, Chicago, IL, 2019
• Sultan RS, Olfson M. Clinical and Demographic Risk Factors for Antipsychotic Prescribing in Youth With ADHD. AACAP Annual Meeting, Seattle, WA, 2018
• Sultan RS, Olfson M. Identifying Problematic Behaviors among Adolescents with ADHD. AACAP Annual Meeting, Washington DC, 2017

NIDA K12 Mentored Clinical Scientist Development Award
Amount: $100,000 | Period: July 2021 - Present | Role: Principal Investigator
Focus: Bioinformatics and Substance Use
Mentors: Frances Levin, MD and Tim Wilens, MD
Institution: Columbia Vagelos College of Physicians and Surgeons

NIMH K08 Career Development Award: Natural Language Processing of EHRs for ADHD Pharmacologic Management
Amount: $400,000 (requested) | Period: 2019-2023 (proposed 4 years) | Role: Principal Investigator
Primary Mentors: Mark Olfson, MD, MPH (Columbia) and Carol Friedman, PhD (Columbia Biomedical Informatics)

Using AI to Improve Mental Health Screening Outcomes
Date: December 2023 | Role: Principal Investigator
Focus: AI/machine learning applications in mental health screening

The Christopher D. Smithers Foundation, Inc.
Role: Principal Investigator | Focus: Addiction research

Explore Related Content

PUBLICATIONS FROM THESE GRANTS - Cannabis & Psychosis publications
CONFERENCE PRESENTATIONS - APSARD 2026 plenary, AACAP cannabis posters
DIGITAL MENTAL HEALTH - JAMA Psychiatry viewpoint on telepsychiatry integration
GRANT TIMELINE - All grants in chronological context
COMPLETE GRANT HISTORY - All grants, funding amounts, dates, roles in complete CV
RESEARCH OVERVIEW - High-level overview of active research projects
SULTAN LAB - Lab overview, team, and resources
IQVIA PRESCRIBING ANALYSIS - National stimulant prescribing study
ADHD IN FEMALES STUDY - MarketScan substance use risk study
CASNY CANNABIS STUDY - Cannabis access and safety in New York