If you are considering psychedelic-assisted treatment in Croatia (for yourself or for someone close to you) two routes are real in July 2026: publicly funded esketamine through hospital psychiatry, and private ketamine therapy in Split. A recruiting study in Zagreb adds a third, narrower door. Psilocybin and MDMA have no legal path. This guide covers who qualifies, how to start, what it costs, and where the public record runs out; you can begin orienting yourself with our eligibility check.
TL;DR Spravato (esketamine) is on HZZO's basic medicines list and funded through the list of especially expensive drugs, for adults whose depression has not responded to at least two different antidepressants in the current severe episode, taken with an SSRI or SNRI. The listed reference price of 237.69 euros per device is charged to the especially-expensive-drugs budget, not to the patient, but no public list of administering hospitals exists, so the route runs through a psychiatrist. Zagreb university psychiatry uses esketamine and is recruiting an observational study around it. Private ketamine therapy is available at Priska Med in Split, self-pay. Psilocybin and MDMA therapy are not legally available.
At a glance
| Route | Substance | Status in Croatia | Who qualifies | Cost |
|---|---|---|---|---|
| Reimbursed esketamine | Esketamine (Spravato) | On HZZO's basic list; funded via the especially-expensive-drugs list; hospital administration | Adults with treatment-resistant depression after at least two failed antidepressants in the current severe episode, with SSRI/SNRI co-treatment | Charged to the HZZO especially-expensive-drugs budget; reference price 237.69 EUR per device |
| Ketamine therapy, private | Ketamine (off-label) | Legal; offered at Priska Med in Split | Clinic screening; aimed at treatment-resistant depression | Self-pay; price not published |
| Esketamine study | Esketamine | Observational study at the University of Zagreb, recruiting | Patients with treatment-resistant depression receiving esketamine; study criteria | Free |
| Psilocybin / MDMA therapy | Psilocybin, MDMA | Research only; no legal route | – | – |
Esketamine (Spravato): funded through the expensive-drugs list
Croatia put esketamine on the national insurer HZZO's basic medicines list, with funding through the Popis posebno skupih lijekova: the list of especially expensive drugs, a separate hospital budget for high-cost therapies (HZZO medicines lists). The published conditions follow the EU label: adults with major depressive disorder who have not responded to at least two different antidepressant treatments in the current severe episode, with esketamine given in combination with an SSRI or SNRI; the listed reference price is 237.69 euros per 28 mg device, charged to the especially-expensive-drugs funds rather than to the patient (Mediately drug register). Administration is supervised, typically twice weekly in the first month, then a maintenance phase at lower frequency (e-pharmaca review).
How to start: through a psychiatrist at a hospital that stocks the drug, as an especially-expensive-drugs therapy, Spravato lives in hospital pharmacies, not retail ones. Bring a written treatment history: drugs, doses, durations, outcomes; documented failure of two adequate antidepressant trials is what the criteria turn on.
Where it happens: HZZO does not publish which hospitals administer esketamine, and that is the biggest practical gap in the Croatian route. Two public signals help. Zagreb's university system is demonstrably active: an observational study at the University of Zagreb is recruiting patients receiving esketamine for treatment-resistant depression (NCT07002684), which only works if the drug is being given there. And the Vrapče psychiatric clinic: Croatia's largest, with a dedicated affective-disorders department (bolnica-vrapce.hr), engages publicly with the ketamine evidence base, publishing plain-language reviews of ketamine trials, including the head-to-head comparison with electroconvulsive therapy (Vrapče on ketamine vs ECT). Neither signal replaces an official centre list; ask your psychiatrist to enquire directly.
Private ketamine therapy: Priska Med in Split
Priska Med, a polyclinic and day hospital in Split, offers ketamine therapy for treatment-resistant depression under what it markets as the "Norwegian protocol", low, medically controlled doses given under the continuous supervision of a physician team. The clinic pitches it at the roughly 30% of patients whose depression does not respond to standard antidepressants (Dalmacija Danas). Prices are not published; ask for a written cost breakdown for the full course, including any preparation and follow-up sessions, before starting. This is off-label ketamine: legal and physician-supervised, but not an HZZO benefit. To see who is listed near you, browse providers in Croatia.
Psilocybin and MDMA: no route
Both remain controlled substances in Croatia with no medical-access, compassionate-use or reimbursement route. Anyone selling psilocybin or MDMA "therapy" in Croatia today is operating illegally. If a regulated psychedelic-therapy framework matters to you, the nearest one being built is Czech medical psilocybin; see our Czechia guide; for research participation, watch ClinicalTrials.gov and the EU CTIS registry, and browse trial sites in Croatia; our trials guide explains how participation works.
What to expect in treatment
Medically reviewed by Dr. Amy Reichelt, PhD, 31 July 2026: this section and the risks section below.
These routes share a shape (medical screening, supervised administration, structured follow-up), but they are not interchangeable: the indication, the schedule, the staffing and the strength of the evidence all differ depending on whether you are prescribed Spravato (esketamine), given ketamine, or entering a legal psychedelic-assisted therapy route, where your country has one. What every route has in common is where it starts. Treatment begins with a screening appointment: the clinician reviews your psychiatric and medication history, checks your cardiovascular health and current medicines, and confirms the diagnosis before anything is scheduled. This is also where contraindications are caught.
On a Spravato day you self-administer the nasal spray in the practice or clinic under supervision, then stay for an observation period of roughly two hours while staff monitor blood pressure, heart rate, sedation, dissociation, breathing and overall recovery. Dissociation, dizziness, sedation, nausea and a temporary rise in blood pressure are common (though they do not occur in everyone), and settle as the drug clears. You must not drive, operate machinery or undertake anything hazardous until the following day, after a night's sleep, so arrange transport home. Induction is typically more frequent at first and then tapers based on measured response. Under the European label, Spravato for treatment-resistant depression is taken alongside a continuing oral SSRI or SNRI antidepressant.
A ketamine infusion for depression is an off-label use of the drug. It is usually given intravenously over about 40 minutes, with vital-sign and psychological monitoring and a recovery period afterwards. Some services offer ketamine-assisted psychotherapy (KAP), which wraps the dosing in preparation and integration sessions with a therapist; others provide ketamine as a medical antidepressant treatment with no psychotherapy component at all, which is worth establishing before you book. Where a legal psychedelic-assisted therapy route exists, and what that route is depends on the country: a clinical trial in most, a regulated programme or compassionate-use scheme in a few; dosing days are long and closely supervised by trained clinical staff, and sit inside a broader plan of preparation, general psychiatric care and integration. In every setting the medicine is one part of the plan: screening, monitoring and follow-up reduce risk but cannot eliminate it, and psychotherapy or integration may help you make sense of what the treatment brings up and apply it afterwards.
Risks and who should not start
These treatments are generally well tolerated under supervision, but they are not for everyone, which is exactly what screening is for. Common, transient effects during or shortly after a session include dissociation (a detached, dreamlike feeling), nausea, mild perceptual changes, and a short-lived rise in blood pressure and heart rate; these resolve as the drug is metabolised. Treatment may be inappropriate, or require particular caution and specialist evaluation, when any of the following apply:
- Uncontrolled hypertension or significant cardiovascular instability, including a history of aneurysmal vascular disease. This is a contraindication for Spravato, because of the temporary rise in blood pressure; the other treatments carry their own cardiovascular assessment.
- A personal or family history of psychosis or bipolar disorder: a particular caution for classic psychedelics such as psilocybin, which legal programmes screen for carefully.
- Pregnancy or breastfeeding.
- Current uncontrolled substance use, a history of ketamine misuse, or a high risk of compulsive use: any of these may make treatment inappropriate or require specialist assessment.
A responsible provider screens for all of these before the first dose. Careful screening, monitoring and follow-up reduce risk; they do not remove it. If a clinic is willing to treat you without that assessment, treat it as a warning sign; see our clinic-choice guide. To see who is listed near you, browse providers in Croatia.
Reviewer's note. Ketamine, Spravato (esketamine) and psilocybin-assisted therapies share common elements such as screening, supervision and follow-up, but they should not be presented as interchangeable. Each has distinct indications, contraindications, monitoring requirements and levels of evidence. Spravato follows a regulated treatment pathway, while IV ketamine is generally used off-label and psilocybin therapies remain largely investigational. Importantly, careful screening and clinical monitoring reduce risk but do not eliminate it.
— Dr. Amy Reichelt, PhD, neuroscientist, chartered psychologist and psychotherapist, PsyAccess medical reviewers
Frequently asked questions
Is Spravato covered by HZZO?
Yes: through the especially-expensive-drugs list, for adults with treatment-resistant depression after two failed antidepressants, taken with an SSRI or SNRI. The cost is charged to a hospital budget rather than to you, but you need a hospital psychiatrist to initiate treatment.
Which Croatian hospitals administer esketamine?
No official list exists. The public record shows activity in Zagreb university psychiatry (an observational esketamine study is recruiting there), and Vrapče runs the country's largest affective-disorders service. Ask your psychiatrist to enquire; do not rely on any commercial directory claiming completeness, including ours.
What does ketamine therapy in Split cost?
Priska Med does not publish prices. Request a written quote for the complete course (screening, dosing sessions and follow-up), and compare it against self-pay ketamine programmes elsewhere in Europe in our cost guide.
Can I get psilocybin or MDMA therapy in Croatia?
No. Both are research-only. Croatian patients looking at the Czech psilocybin framework should read our Czechia guide for what that rollout actually allows: it is built for the Czech system, not for treatment travel.
Coming from another country? Whether a clinic will take a non-resident self-pay patient, what a Spravato induction schedule means for a visitor, and where cross-border treatment actually works: ketamine & psychedelic therapy in Europe for international patients.
Sources
- Mediately: Spravato 28 mg — Croatian registration, especially-expensive-drugs listing and reference price
- HZZO: Published medicines lists
- e-pharmaca: Esketamin (Spravato) za terapijski rezistentnu depresiju — critical review with Croatian coverage context
- ClinicalTrials.gov: NCT07002684 — Metabolic profiling of esketamine treatment, University of Zagreb (recruiting)
- Klinika za psihijatriju Vrapče: Ketamine or ECT for depression — first head-to-head results
- Klinika za psihijatriju Vrapče: Department for affective disorders
- Priska Med, Split: Ketamine therapy — the "Norwegian protocol"
- Dalmacija Danas: What is the "Norwegian protocol" and why is it controversial?
- EMA: Spravato (esketamine) EPAR
This guide is for general information only and is not medical advice, a diagnosis, or a recommendation of any treatment. List conditions and hospital practice change; always verify current requirements with HZZO, HALMED, or a licensed clinician who knows your history. If you are in crisis, contact your local emergency number or a crisis line immediately.
This guide awaits review by a licensed medical professional.