EP302: Ryan Nau, CRNA - CTK, TMS, Ketamine & the Future of Mental Health Treatment

In this wide-ranging conversation, Alex sits down with Ryan Nau, CRNA, owner/operator of Satori Integrative Medicine Clinic in Glenwood Springs, Colorado. Ryan shares his background in anesthesia and rural medicine and how he became an early adopter of CTK, an emerging treatment approach that Combines Transcranial Magnetic Stimulation (TMS)—a noninvasive therapy that uses magnetic pulses to stimulate specific areas of the brain—with Ketamine, an established treatment used in mental health care. His passion and commitment to helping others have created a safe place for people to explore science-based alternatives to more traditional treatment protocols. Ryan has the ability to custom-tailor treatment to the individual, which may include Ketamine-Assisted Psychotherapy (KAP), Ketamine alone, TMS alone, CTK, or a multitude of options. From his clinic in Glenwood Springs, Ryan is bringing these treatment options to patients throughout Colorado’s Western Slope and the Roaring Fork Valley. The conversation explores both the promise and limitations of these treatments—including side effects, contraindications, cost, stigma, addiction, patient safety, and what Ryan is seeing firsthand in clinical practice. Alex also shares his own experience as a long-term ketamine patient and discusses how his response to treatment has changed over time. TIMESTAMPS 00:23 — Meet Ryan Nau, CRNA 01:09 — Ryan’s education, anesthesia background & rural medicine 02:09 — Practicing medicine in rural Colorado and Meeker 06:31 — Satori Clinic in Glenwood Springs 06:46 — Transparency, conflicts of interest & Alex’s patient relationship with the clinic 07:52 — What is CTK? Combining TMS + ketamine 10:22 — Medical disclaimer—and Alex’s unforgettable colonoscopy/IV story 15:49 — Informed consent and potential treatment risks 16:13 — TMS injury reports and separating anecdotal reports from clinical evidence 18:25 — Ryan discusses TMS side effects, safety and contraindications 22:57 — Shifting the conversation to ketamine 23:22 — Dissociation, “bad trips” and the ketamine experience 25:54 — Ketamine side effects and blood-pressure concerns 27:10 — The three barriers to ketamine: cost, stigma & fear 28:10 — Who should—and shouldn't—receive ketamine? 29:03 — Ketamine abuse, bladder problems and the difference between clinical and recreational use 31:31 — The “P pill”: reducing the urge to urinate during an infusion 33:28 — Why small distractions can derail a ketamine experience 34:32 — Ryan’s West Virginia roots and path into anesthesia 35:57 — Bringing ketamine treatment to the Roaring Fork Valley 38:00 — What the early days of ketamine treatment looked like 49:52 — The Achilles’ heel: treatment isn’t necessarily “one and done” 49:58 — Do you need a physician referral for treatment? 51:07 — Addiction, alcohol, opioids, ketamine and ibogaine 1:04:08 — Ketamine and alcohol dependency: what do we actually know? 1:05:54 — Why ketamine may work best as part of a bigger treatment strategy 1:14:15 — What happens when a new patient contacts Satori Clinic? 1:14:23 — Screening, contraindications, treatment options and the six-treatment protocol 1:35:31 — Alex describes diminishing returns after years of ketamine treatment 1:36:32 — Deciding to try combined TMS + ketamine 1:38:16 — Alex’s first ketamine infusion—and the moment his mother noticed the difference 1:39:26 — Exploring psychedelic medicine and the 2023 psychedelic conference 1:40:10 — Ayahuasca, iboga and ibogaine experiences 1:40:37 — Ibogaine, Colorado law and the developing psychedelic-treatment landscape [email protected] Audio sourced by: www.Pond5.com Feel Invisible? Got a case of the Fuckits? Text or call 988 or if the Fecal is Hitting the Fan, call 911.