En bref, en français. En France, la kétamine et l'eskétamine (Spravato) ne sont accessibles qu'à l'hôpital : le Spravato est réservé aux adultes de moins de 65 ans après échec d'au moins deux antidépresseurs de deux classes différentes, et depuis mars 2026 un cadre de prescription compassionnelle de l'ANSM encadre la kétamine IV pour les idées suicidaires sévères. Il n'existe pas de marché de cliniques privées de kétamine en France, et la psilocybine comme la MDMA restent réservées aux essais cliniques. Nos guides en français : Spravato : quel prix en France ? · Le remboursement de l'eskétamine en 2026 · Où trouver un traitement à la kétamine ?. Le guide complet ci-dessous est en anglais.
If you are considering psychedelic-assisted treatment in France — for yourself or for someone close to you — one fact organises everything else: France treats these medicines as hospital medicine, full stop. There is no private clinic market to compare prices in and no designated-center list to pick from; every legal route in July 2026 runs through hospital psychiatry, whether that is esketamine under narrow criteria, ketamine in a suicidal crisis, or a clinical trial. This guide covers who qualifies for each route, how to start, what it costs, and what to realistically expect; you can begin orienting yourself with our eligibility check.
TL;DR Spravato (esketamine) is available in France through hospital psychiatry only, under narrow criteria: adults under 65 whose current episode failed at least two antidepressants from two different pharmacological classes. Ketamine for depression is likewise hospital-only, and in March 2026 the ANSM created a compassionate prescribing framework covering IV ketamine for severe suicidal ideation. Private ketamine clinics as seen in Germany or the UK effectively do not exist in France. Psilocybin and MDMA are research-only: a Phase 3 psilocybin trial for alcohol use disorder is recruiting at CHU Nîmes, and no French MDMA trial is recruiting.
At a glance
| Route | Substance | Status in France | Who qualifies | Cost |
|---|---|---|---|---|
| Hospital esketamine | Esketamine (Spravato) | Available within hospital psychiatry; running | Adults under 65 whose current episode failed at least 2 antidepressants from 2 different pharmacological classes | Covered by public insurance within hospital care |
| Hospital ketamine | Ketamine (racemic, IV) | Hospital-only; ANSM compassionate framework (CPC) since March 2026 for severe suicidal ideation | Hospital team's protocol decision; the CPC targets adults in suicidal crisis | Covered within hospital care |
| Private ketamine clinics | Ketamine | Effectively no such market in France | — | — |
| Psilocybin | Psilocybin | Research only; one Phase 3 trial recruiting at CHU Nîmes | Study-specific criteria (alcohol use disorder with depressive symptoms) | Free in trials |
| MDMA | MDMA | Research only; no French trial currently recruiting | — | — |
| Clinical trials | Ketamine, esketamine, psilocybin, LSD | 27 French-linked studies tracked, 5 active | Study-specific criteria | Free |
Full coverage details: Is Spravato reimbursed in France?
Esketamine (Spravato): narrow criteria, hospital setting
Esketamine nasal spray is dispensed and administered within hospital psychiatric services. The French coverage framework is narrower than the EU label: it targets adults under 65 with a depressive episode that has resisted at least two antidepressants from two different pharmacological classes, taken at adequate dose and duration in the current episode. Assessment, initiation and the supervised dosing sessions all happen in the hospital; French health authorities — the HAS for reimbursement assessment and the ANSM for safety framing — have kept the drug inside that perimeter, and there is no retail pharmacy reimbursement route (HAS, ANSM, EMA product information).
Practically, this means eligibility is decided twice: first by your treating psychiatrist, who documents your treatment history and decides whether to refer, and then by the hospital team, which applies its internal protocol before scheduling treatment. Neither step can be skipped, and both run on documentation, so the written medication history you bring to the first appointment matters more than anything you say in it. Note the class of each drug you have tried; the two-classes criterion makes that detail decisive.
How to start: Begin with your treating psychiatrist, or ask your GP for a psychiatric referral — nothing moves without a specialist who supports it. Ask specifically which regional hospital runs an esketamine program and how long the assessment queue is; university hospital centers (CHU) are the usual anchors. Between the referral, the hospital's own assessment and scheduling, several months is common. Treatment itself is covered by public insurance within hospital care; for how France compares with its neighbours, see our Europe-wide reimbursement map.
Ketamine: hospital-only, with a 2026 compassionate framework
Racemic ketamine for depression is also confined to hospital use in France. In March 2026 the ANSM put a compassionate prescribing framework (cadre de prescription compassionnelle, CPC) in place covering IV ketamine for severe suicidal ideation in adults — formalizing what specialized hospital units were already doing and giving prescribers a defined protocol (ANSM). This is an acute-care tool used by hospital teams during a crisis, not a bookable therapy course and not something you can request at a private practice; it did not turn ketamine into an ordinary community psychiatric medicine.
The consequence for patients is blunt: there is no private ketamine clinic market in France. Offers of private "ketamine therapy" in France should be treated with extreme caution — the legitimate route runs through hospital psychiatry. To see what is listed for France, browse providers in France.
Psilocybin: research-only, with Nîmes as the anchor
Psilocybin is a controlled narcotic in France with no medical-access or compassionate route — lawful use exists only inside ANSM-authorised clinical trials. The research, however, is real and centred on CHU Nîmes, where Amandine Luquiens led the IReSP-funded PAD pilot of psilocybin-assisted treatment for alcohol use disorder (Blossom France country report).
Where things stand in July 2026:
- The follow-on Phase 3 trial — psilocybin for relapse prevention in alcohol use disorder with depressive symptoms — is recruiting at CHU Nîmes, having started in June 2026 (NCT07638553). This is currently the one recruiting psilocybin trial in France.
- A Phase 2 pilot of psilocybin-assisted psychotherapy for gambling disorder is registered but not yet recruiting (Blossom France country report).
- Earlier French psilocybin studies — including PSILODAC, on psilocybin in treatment-resistant depression — have completed.
If your situation fits the Nîmes trial's target profile, ask your psychiatrist or addiction specialist about a referral to the study team. Outside a trial, anyone selling psilocybin therapy in France today is operating illegally.
MDMA: research participation only — and nothing is recruiting
MDMA remains a controlled narcotic in France with no medical-access route, and the research picture is thinner than for psilocybin: as of July 2026, no French MDMA trial is recruiting, and Blossom's France tracker lists no active MDMA study at all (Blossom France country report). If MDMA-assisted therapy matters to you, the realistic options are watching the registries for new French studies or considering trial sites elsewhere in Europe — our trials guide explains how to search and what participation involves. Anyone offering MDMA therapy commercially in France today is operating illegally.
Clinical trials in France
Blossom currently tracks 27 psychedelic clinical trials connected to France, 5 of them active, with ketamine and esketamine the most-studied compounds and depression the dominant topic (Blossom France country report). Recruiting studies in mid-2026 include the Nîmes psilocybin Phase 3, MOODBOOSTER — an AP-HP Phase 3 trial of ketamine added to venlafaxine in severe depression (NCT06508710) — and EMOKET, a ketamine mechanism study at Centre Hospitalier Sainte-Anne in Paris. France also hosts sites of the international Phase 3 MM120 (LSD) program for generalised anxiety disorder, which is active but no longer enrolling. Most of this activity sits in Paris — regulator, HTA body, academic psychiatry and Phase 3 participation — with Nîmes and Marseille as the other centres.
Participation is free and legal, but screening is strict and enrolment is never guaranteed, and trial screening can run in parallel while you wait for a hospital program. See the trials guide for how phases, placebo and consent work, and search ClinicalTrials.gov for current French listings.
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 France.
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 review board
Frequently asked questions
Can I get Spravato from a private psychiatrist in France?
No. Initiation and administration happen in hospital psychiatric services. A private psychiatrist's role is to document your history and refer you.
I am over 65 — do I have any options?
The French Spravato framework targets adults under 65. Discuss alternatives with your psychiatrist: hospital ketamine protocols, ECT, other augmentation strategies, or trials without the same age cutoff.
Is psilocybin therapy available in France right now?
Only inside a clinical trial. The one recruiting French psilocybin study is the CHU Nîmes Phase 3 trial for alcohol use disorder with depressive symptoms; there is no compassionate or special-access program for classical psychedelics.
What about MDMA therapy?
Not outside research, and as of July 2026 no French MDMA trial is recruiting at all. Watch the registries or consider trial sites elsewhere in Europe; anyone selling MDMA therapy in France today is acting illegally.
How long does the hospital route take?
It varies by region and program; between the psychiatric referral, the hospital's own assessment and scheduling, several months is common. Asking about the queue up front helps you plan, and trial screening can run in parallel.
How long is a session, and can I drive afterwards?
Budget most of a morning or afternoon: a short administration plus an observation period of typically around two hours for esketamine, or a 40–60 minute infusion plus recovery for hospital ketamine. You must not drive until the next day, after a restful sleep, so plan a lift home.
Sources
- ANSM — Agence nationale de sécurité du médicament
- HAS — Haute Autorité de Santé
- EMA: Spravato product information
- Blossom: France country report
- Blossom: Medical access in France
- Psychedelic Alpha: Worldwide psychedelic laws tracker
- ClinicalTrials.gov: NCT07638553 — Psilocybin in alcohol use disorder with depressive symptoms, CHU Nîmes (recruiting)
- ClinicalTrials.gov: NCT06508710 — MOODBOOSTER, ketamine with venlafaxine in severe depression, AP-HP (recruiting)
- Base de données publique des médicaments
This guide is for general information only and is not medical advice, a diagnosis, or a recommendation of any treatment. Regulations and reimbursement rules change; always verify current requirements with your hospital team and discuss your options with a licensed clinician who knows your history. If you are in crisis, contact your local emergency number (in France: 15, or the national suicide prevention line 3114) immediately.
This guide awaits review by a licensed medical professional.