United Kingdom

One licence, three answers. In Scotland the SMC accepted Spravato for restricted NHS use under a patient access scheme (SMC2258) — the route runs via your psychiatrist and health board. In England and Wales NICE declined to recommend it (TA854), and Northern Ireland endorsed that decision, so the NHS route there is effectively closed.

Legal off-label at CQC-registered clinics — the most developed private market in Europe. Roughly £300–800 per infusion; ketamine-assisted psychotherapy programmes from ~£6,000; a few NHS trusts run self-funded services (~£3,000/year at Oxford Health). Check the clinic’s CQC profile and the prescriber’s GMC number before paying. Watch item: the Home Office is reviewing ketamine’s classification (possible Class B→A) — it would raise penalties for misuse, not remove the Schedule 2 medical pathway.

£300–800/infusion · KAP from ~£6,000

Class A, Schedule 1 (Misuse of Drugs Regulations 2001) — no prescription or compassionate route; anyone selling psilocybin therapy in the UK is acting illegally. The trial pipeline is real: CYB003 Phase 3 for depression is recruiting at UK sites (NCT06793397), Imperial’s PsiloIMAGINE is recruiting (NCT06798636), and the COMP360 Phase 3 programme included UK sites.

Class A, Schedule 1. As of July 2026 no UK MDMA trial is listed as recruiting on ClinicalTrials.gov — the realistic options are watching the registry or trial sites elsewhere in Europe.

Legal since 1 November 2018 by specialist prescription; in practice almost entirely via private clinics.

One of Europe’s busiest scenes: 67 UK-linked studies tracked, 12 active — London hub (Imperial, King’s, UCL, commercial sites like Clerkenwell Health). Participation is free; screening is strict; never pay for “trial access”.