Ryan S. Sultan, MD

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PAWS Project (Pawsitive Companion)

Multi-Modal AI System for Cannabis Use Disorder Treatment

Grant Mechanism: UG3/UH3 | Role: Multi-Principal Investigator (MPI)

PAWS is a multi-modal AI system designed to transform evidence-based Cannabis Use Disorder (CUD) treatment into engaging acts of caring for a digital pet. This innovative approach is specifically designed to reach youth in underserved areas where specialized addiction care is often inaccessible.

My Responsibilities as MPI:

• Clinical-Informatics Integration: Lead translation of CUD treatment protocols into algorithmic logic for the AI agent, ensuring developmental appropriateness
• Youth Engagement Strategy: Oversee recruitment and retention of youth cohort at NYPSI, leveraging dual training in child and adult psychiatry to manage complex comorbidities
• Data Analysis: Co-lead data analysis of both feasibility (UG3) and efficacy (UH3) trials

Collaborators: Dr. Xu (Technical Architecture Lead), Dr. Frances Levin (Clinical Trial Regulatory Framework Lead)

Significance: This project represents a pivotal step in my transition to independent leadership, applying scalable technology to resolve critical access barriers in youth addiction treatment. This work builds on Dr. Sultan's published JAMA Psychiatry viewpoint on integrating telepsychiatry and digital mental health into clinical practice.

Career Development & Training Trajectory

NIDA K12 Mentored Clinical Scientist Development

Period: 07/2021 - 06/2026
Mentor: Frances Levin, MD
Institutions: Columbia University & Mass General/Harvard
Focus: Patterns and outcomes of adolescent substance use and ADHD-related risk behaviors

Key Achievement: 2023 JAMA Network Open publication establishing that even non-disordered cannabis use below diagnostic thresholds serves as a meaningful risk marker for depression (2-4x higher odds), suicidality (2-4x higher odds), academic problems (2-4x higher odds), and psychosocial difficulties (2-4x higher odds). This highlights an opportunity to intervene early in the trajectory of youth suicide risk.

NIMH T32 Translational Research Fellowship

Period: 07/2016 - 06/2019
Primary Mentor: Mark Olfson, MD, MPH
Secondary Mentor: Jonathan Posner, MD (Year 2)
Institution: Columbia University
Role: Chief Research Fellow (Year 2)

Research Focus: Psychopharmacological epidemiology using large national datasets (IQVIA, MarketScan, NCS-A) examining adverse outcomes in youth with ADHD, prescribing patterns, and effects of FDA changes to clozapine prescribing guidelines.

Contributions to Science

1. Cannabis & Substance Use (Adolescents / Young Adults)

My work has examined how patterns of access, exposure, and use of substances intersect with developmental vulnerability in adolescents. Across multiple national studies, I have demonstrated that cannabis use among U.S. adolescents is both widespread and clinically consequential—even in the absence of a formal substance use disorder.

Key Findings: Adolescents engaging in non-disordered use experienced substantially higher odds of depression, suicidality, academic impairment, and psychosocial difficulties compared to non-users, with risks escalating further among those meeting criteria for cannabis use disorder. Youth access to cannabis—particularly through unlicensed retailers and inadequately labeled products—remains pervasive in New York.

Peer-Reviewed Publications (5):

1. Sultan, R. S., Zhang, A. W., Becker, T. D., et al. (2026). Cannabis use among U.S. adolescents. Pediatrics, 157(1), e2024070509.
2. Becker, T. D., Menzi, P. J., Olfson, M., et al. (2025). Labeling of cannabis products from licensed and unlicensed retailers in New York. American Journal of Preventive Medicine, 69(5), 108000.
3. Becker, T. D., Olfson, M., Menzi, P. J., et al. (2025). Cannabis access by retailer type in New York. Pediatrics, 155(3), e2024068669.
4. Sultan, R. S., Zhang, A. W., Olfson, M., et al. (2023). Nondisordered cannabis use among U.S. adolescents. JAMA Network Open, 6(5), e2311294.
5. Olfson, M., Wall, M., Liu, S., Sultan, R. S., & Blanco, C. (2019). E-cigarette use among young adults in the U.S. American Journal of Preventive Medicine, 56(5), 655–663.

2. Substance Use and ADHD

Given my research interest in both ADHD and substance use, I have explored how these domains interact. My work demonstrates that even youths who do not meet criteria for substance use disorders but engage in occasional use are at elevated risk for adverse outcomes.

Key Findings: Non-disordered cannabis users had 2–4 times higher odds of developing depression, suicidal thoughts, academic problems vs. non-users, while those with cannabis use disorder had even higher risks. Any regular substance use can be a red flag for underlying distress or future problems, especially in youth with ADHD who may be self-medicating.

Peer-Reviewed Publications (3):

1. Sultan, R. S., Saunders, D. C., & Veenstra-VanderWeele, J. (2025). Protective effects of ADHD medication on real-world outcomes. JAMA Psychiatry.
2. Sultan, R. S., Zhang, A. W., Olfson, M., et al. (2023). Nondisordered cannabis use among U.S. adolescents. JAMA Network Open, 6(5), e2311294.
3. Sultan, R. S., Liu, S. M., Hacker, K. A., & Olfson, M. (2021). Adolescents with ADHD: Adverse behaviors and comorbidity. Journal of Adolescent Health, 68(2), 284–291.

3. Treatment Patterns and Outcomes for Youth

Using epidemiologic methods and administrative datasets, I have advanced our knowledge on several domains for youth. I described pharmacologic treatment patterns of youth, high-risk outcomes in ADHD youth, and antipsychotic and stimulant treatment patterns.

Key Findings: Identified national trends in rates of prescribing of antipsychotics in ADHD youth, demonstrated links to comorbidity, and identified potential problematic prescribing. Adolescents with ADHD have elevated risks for suicide behaviors, aggression, emotional dysregulation, and legal issues.

Peer-Reviewed Publications (4):

1. Sultan, R. S., Saunders, D. C., & Veenstra-VanderWeele, J. (2025). Protective effects of ADHD medication on real-world outcomes. JAMA Psychiatry.
2. Sultan, R. S., Liu, S. M., Hacker, K. A., & Olfson, M. (2021). Adolescents with ADHD: Adverse behaviors and comorbidity. Journal of Adolescent Health, 68(2), 284–291.
3. Sultan, R. S., Wang, S., Crystal, S., & Olfson, M. (2019). Antipsychotic treatment among youths with ADHD. JAMA Network Open, 2(7), e197850.
4. Sultan, R. S., Correll, C., Schoenbaum, M., et al. (2018). National patterns of commonly prescribed psychotropic medications to young people. Journal of Child and Adolescent Psychopharmacology.

4. Psychopharmacology Safety, Prescribing, and Nomenclature

Another focus of my work has been improving the safety and understanding of psychiatric medications. Through research on rates of neutropenia and agranulocytosis for clozapine-treated individuals, and work to advance neuroscience-based nomenclature, I have contributed to safer prescribing practices.

Key Findings: New FDA monitoring guidelines are likely to substantially reduce the percentage of patients who meet criteria for clozapine-associated hematologic events requiring treatment interruption, potentially increasing access to this uniquely effective medication for treatment-resistant schizophrenia.

Peer-Reviewed Publications (2):

1. Sultan, R. S., Correll, C. U., Zohor, J., et al. (2018). What's in a name? Moving to neuroscience-based nomenclature in pediatric psychopharmacology. Journal of the American Academy of Child & Adolescent Psychiatry, 57(10), 719–721.
2. Sultan, R. S., Olfson, M., Correll, C., & Duncan, E. (2017). Evaluating the effect of the changes in FDA guidelines for clozapine monitoring. Journal of Clinical Psychiatry.

Pioneering Clinical Research

Ketamine for Treatment-Resistant Depression

I have been at the forefront of ketamine research for treatment-resistant depression since 2011. Under the guidance of Yale psychiatrist Dr. John Krystal, the pioneering researcher who discovered ketamine's rapid antidepressant effects, I became the first psychiatrist to combine ketamine with Electroconvulsive Therapy (ECT) for severe depression, combining the rapid antidepressant effects of ketamine with the proven efficacy of ECT.

As Director of the Sultan Lab for Mental Health Informatics, my lab is focused on understanding the mechanisms of ketamine's antidepressant effects, investigating ketamine's role in promoting neurogenesis, refining treatment protocols for optimal safety and efficacy, and educating clinicians and the public about ketamine's therapeutic potential.

Research Support & Funding

Total Active Funding: $670,000+

Research Stabilization Fund (Columbia University) - PI

06/2025-06/2026. Columbia-supported grant to provide bridge funding for early-career research; supports ongoing analyses of ADHD treatment patterns in large datasets.

NIDA K12 Substance Use Clinical Scientist Career Development Award - Scholar/PI

07/2021-06/2026. Columbia University & Mass General/Harvard. Mentored career development award focusing on adolescent substance use and comorbid ADHD.

AACAP Elaine Schlosser Lewis Award (Pilot Research Award) - PI

10/2016-10/2017. Award from AACAP to support research on attention disorders. Funded work utilizing private and public insurance claims (MarketScan, Medicaid) to profile treatment of youth with ADHD and disruptive behavior disorders.

NIMH T32 Translational Research Fellowship - Postdoctoral Fellow (Chief Research Fellow, Year 2)

07/2016-06/2019. Columbia University (PI: Veenstra-VanderWeele). NIMH-funded postdoctoral training program in child psychiatry research at Columbia University.

Additional Honors & Leadership Roles

2025

Journal Reviewer - American Journal of Psychiatry, British Journal of Psychiatry, BMJ Group, JAACAP Open, JAMA Network Open

2025

Reviewing Editor, Springer Nature Reviewer Communities for BMC Psychiatry

2023-Present

AACAP Pharmacology and Neurotherapeutics Committee

2021-Present

Director, Sultan Lab for Mental Health Informatics at Columbia University (Team of 7 researchers)

2019

Excellence in Teaching, Columbia and Creedmore Residents

2018

Chief Fellow, Columbia University Irving Medical Center

2017

Chief Research Fellow, T32 Postdoctoral Fellowship for Translational Research in Child Psychiatry, Columbia University

2016

AACAP Pilot Research Award for Child Psychiatry Residents and Junior Faculty

2014-Present

Medical Director, Integrative Psych (Team of 10 clinicians). Learn more about his integrative psychiatry approach in Manhattan.

2011

Resident Teaching Award, Emory School of Medicine

2006

Human Relations Award, Trinity College

Patents & Clinical Innovations

Patent Applications in Development (2025):

1. Psychiatric Education Assessment Tool (PEAT) - Under Development (February 2025 - Present). Innovative assessment tool for psychiatric education and training evaluation.
2. Cannabis Assessment Psychoeducation Tool and Intervention (CAPTI) - Under Development (February 2025 - Present). Clinical tool for assessing cannabis use and delivering targeted psychoeducational interventions.
3. Integrative Model of Care - Under Development (April 2025 - Present). Collaborator: Dr. Timothy Becker. Developing an integrative model of care integrating the biopsychosocial model in the advanced care model.

Consultation & Advisory Work

2020-2023

Avenues: The World School, Chelsea Campus - Consultation on Youth Mental Health During the COVID-19 Pandemic. Provided expert guidance on adolescent mental health strategies during the pandemic.

2017-2018

New York Center for Autism Charter School - Behavioral & Psychopharmacological Consultation. Specialized consultation on autism spectrum disorders and medication management.

Explore Related Content

• FULL GRANT METHODOLOGIES - Complete research methodology for Cannabis & Psychosis grant and other funded projects
• ALL PEER-REVIEWED PUBLICATIONS - Complete bibliography with DOIs and PubMed IDs for all 14+ peer-reviewed publications
• CONFERENCE PRESENTATIONS - All conference presentations including invited plenary talks and poster presentations
• COMPLETE CAREER TIMELINE - Year-by-year chronology from medical school through present
• ACTIVE RESEARCH PROJECTS - Current research focus and ongoing projects at Sultan Lab
• COMPLETE ACADEMIC CV - Full curriculum vitae with all training, positions, grants, and academic activities
• TEACHING HISTORY - Teaching activities, educational leadership, and mentorship