Fern Clyde wins at Pontefract! Our 18th winner of 2026!! Congratulations to the owners @ramshroff @NBradleyRacing @EasterbyTim

Elusive Butterfly wins a listed race at Epsom!! Our 17th winner of the year!!! Congratulations to the owners and @NBradleyRacing @ramshroff @CliffordleexLee @karl_burke

Azure Zain wins at Ascot!! Our 16th winner of 2026!!! Congratulations to the owners @MprUpdates @ramshroff

Magician of Riga wins at Southwell!! Our 15th winner of 2026!!! Congratulations to the owners @ramshroff @MprUpdates

Go Lockers Go wins at Yarmouth!!! Our 14th winner of 2026!! Congratulations to the owners and @ramshroff @MprUpdates

Two winners today!!! She’s Got A Brother wins again 2/2 at Southwell!! Our 13th winner of 2026!!! Congratulations to all owners and @ramshroff @MprUpdates

Cool Molly wins for the 4th time in 2026 at Southwell!! Congratulations to the owners and @NBradleyRacing @ramshroff

She’s Got A Brother wins on debut at Southwell! Our 11th winner of 2026!!!Congratulations to the owners and @MprUpdates @ramshroff #nursepractitioner #psychiatry

Magician of Riga wins at Wolverhampton! Our 10th winner of 2026!!! Congratulations to the owners and @MprUpdates @ramshroff

Cool Molly wins at Lingfield!! 9th winner of 2026!!! Congratulations to the owners and @NBradleyRacing 🥂 @ramshroff @OllieSangster

Here is the distribution of placebo responses in major depression (MDD) and treatment resistant depression (TRD), the four vertical lines are the four recent psychedelic trials I mentioned below. There is a lower placebo response in TRD, however the psychedelic studies appear even lower than those, the avg across these 4 trials is ( 0.3-3.7-1.2-1.5)/4~-1.5. For MDD replotting data from: tinyurl.com/mp93f37n For TRD replotting data from: tinyurl.com/msfuhz7d

Go Lockers Go wins at Chelmsford! 8th winner of 2026!! Congratulations to the owners and @MprUpdates @ramshroff

Another day, another psychedelic trial with missing placebo response (tinyurl.com/3pzpxpac), this time with 5-MeO-DMT. In this case the patients actually got WORSE in the placebo group. In the past month, 4 high profile psychedelic trials came out, all on treatment-resistant depression, all showing the same phenomena: there is virtually no placebo response in the control arm of psychedelic studies, see image below (negative values indicate improvement as you want less depression): A: 5-meo vs PL, placebo response is 0.3 MADRS units (tinyurl.com/3pzpxpac) B: psilocybin vs active PL (nicotinamide), placebo response is -1.5 MADRS units (tinyurl.com/yueyphn5) C: psilocybin vs PL, placebo response is -1.2 MADRS units (COMP005 tinyurl.com/cjjmh8x7) D: psilocybin vs active PL (1mg psilocybin), placebo response -3.7 MADRS units (COMP006 tinyurl.com/cjjmh8x7) The typical placebo response in trials on major depression of antidepressants is -9 MADRS points (shorturl.at/fwTNs). The typical placebo response in trials on TRD with ketamine -7 MADRS points (shorturl.at/ZS0QQ).

The benefits of psilocybin for major depression have been greatly exaggerated and the risks have been minimized!!! Nine months ago when the first of two Compass Pathways studies for MDD were released I stated on X on 6/23/25 that unblinding was a major problem in the psilocybin studies. Last week a meta-analysis by Williams et. al. in JAMA Psychiatry and a negative DB study (psilocybin) in treatment resistant depression in 144 patients by Mertens et. al. in JAMA Psychiatry confirmed my conclusions from nine months ago. Conclusions from meta-analysis: "In trials of depression, PAT( psychedelic assisted therapy) was not more effective than open-label TADs (traditional antidepressants). Blinding made a difference for TADs, but not for PAT, confirming that PAT trials are effectively always open label." There is a lot of money chasing psychedelics (both private and public) which accounts for the hype with very little substance. Clinicians and the FDA should be highly skeptical of this class of medications so that we do not have another opioid epidemic with needless prescribing with high risk and little benefit compared to existing treatments. It is not as if psychiatry did not extoll the benefits of psychedelics (mescaline, LSD etc.) in the 1950s and early 60s eventually leading to abuse and the FDA and government stepping in. My partner Chris Aiken, MD has an excellent summary. bit.ly/4c5CGev

In patients with bipolar I disorder antidepressant use increases manic/mixed episode hospitalization risk by approximately 30%, with differential effects across treatment strategies and patient subgroups. Combining ADs with mood stabilizers appears to mitigate this risk, while mixed episodes and younger age represent particularly high-risk scenarios. Its very important to screen all depressed patients for bipolar disorder and not use antidepressant monotherapy in bipolar patients.bit.ly/4sk92Zl

Cool Molly wins again at Lingfield!! Our 7th winner of 2026🥂Congratulations to the owners and @NBradleyRacing @ramshroff @OllieSangster #nursepractitioner #psychiatry