Switzerland

On the Spezialitätenliste since 1 October 2025 (temporary limitations to 30 September 2028), under a strict Limitatio: ages 18–74, severe treatment-resistant episode, 2 failed antidepressants plus 1 augmentation attempt, CGI-S ≥5, ECT not indicated/refused/inaccessible. Reimbursed only at the 52 BAG-designated centers after the insurer’s trust doctor approves — and coverage caps at 10 months (extendable twice by 3).

Off-label infusions around CHF 300–500, self-pay — a 2023 request to add ketamine to the reimbursement annex was rejected. Verify authorization via MedReg.

CHF 300–500/infusion

Europe’s longest-running programme: under Article 8 of the Narcotics Act, the FOPH grants case-by-case authorizations to individual physicians for named patients — psilocybin since 2021. Documented scale: ~100 authorized physicians treated 723 patients in 2024 (BAG expert report). Access runs through the physician, not the BAG — no self-application, no public permit list, waitlists of many months, usually self-paid, built for patients in Swiss care.

Same Article 8 programme, MDMA since 2014 — mostly for PTSD, typically 2–4 dosing sessions within 12 months inside ongoing psychotherapy. This is the single legal MDMA-therapy route in Europe; it is physician-gated and not built for treatment tourism. LSD is available under the same mechanism.

LSD is available under the same Article 8 mechanism as psilocybin and MDMA — the only legal LSD-therapy route in the world, physician-gated and named-patient.

Medical: prescribable without special authorisation since the August 2022 BetmG amendment. Non-medical: seven regulated-sale pilot trials (~10,000 participants — Basel, Zurich, Lausanne, Geneva and others) run under a 10-year Narcotics Act amendment, and a draft national adult-use law entered consultation in 2025.

Europe’s densest scene: 73 studies tracked, 15 active — Basel (clinical pharmacology) and Zurich (neuroimaging) anchor it; LSD, MDMA, psilocybin and 5-MeO-DMT studies. Participation is free; screening is strict; never pay for “trial access”