United States

FDA-approved for treatment-resistant depression (2019) and — since 2025 — as monotherapy; administered under the Spravato REMS programme at certified treatment centers with post-dose observation. Coverage depends on your insurance plan.

Generic ketamine is legally prescribed off-label for depression across the country — the widest access in the world, and also the least regulated per-clinic, so screening quality varies. Check state licensing and demand psychiatric screening before paying.

Schedule I federally. State frameworks: Oregon (Measure 109 — licensed service centers since 2023, no diagnosis required), Colorado (Prop 122 — healing centers, first licenses 2025), Utah (SB 266 pilot), New Mexico (SB 219 medical program). Everywhere else: trials only.

The FDA declined the first MDMA-assisted therapy application in August 2024 and requested an additional Phase 3 trial; as of July 2026 no new Phase 3 has launched (realistic resubmission 2028+). One structural step: in July 2026 the FDA finalized its psychedelic clinical-trial guidance — the formal answer to functional unblinding that any new MDMA trial must meet. Re-check at every review.

Medical programs in ~40 states, adult-use in ~24; federally still Schedule I.

Schedule I with no access route — but the research picture is moving fast: Texas SB 2308 (signed 11 June 2025) established a consortium for FDA-supervised ibogaine trials, with $50M appropriated alongside it (conditioned on a private match; in March 2026 the program pivoted to state-run trials at UTHealth Houston and UTMB — the largest state investment in ibogaine research in US history). Mississippi, Indiana and California followed with their own measures, and Stanford’s 2024 Nature Medicine study of veterans treated in Mexico put ibogaine on the mainstream research map. Watch this cell at every review.

The world’s largest pipeline — hundreds of studies across psilocybin, MDMA, LSD analogs and ketamine. Search by condition + state. Participation is free; screening is strict; never pay for “trial access”.