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UMC Utrecht

Utrecht, Netherlands

Treatment & access

About this provider

UMC Utrecht provides esketamine nasal spray as an outpatient programme of its Psychiatry department (Polikliniek Stemming & Psychose). Every patient first has a second-opinion consultation with a UMC Utrecht psychiatrist, after referral by the GP or mental health clinician via the Advies- & aanmeldteam, followed by a safety screening. The spray is always self-administered in hospital with a professional caregiver present and blood pressure checks; sessions take two to three hours plus 30 to 60 minutes preparation. The first four to six weeks run twice weekly; treatment continues only if symptoms improve, tapering step by step, and by national agreement lasts at most six months. Esketamine is embedded in a broader depression treatment, with questionnaires that also support the P-TRD study.

Services & programs

  • Esketamine nasal spray as outpatient treatment at the Psychiatry department (Polikliniek Stemming & Psychose)
  • Pre-treatment second-opinion consultation with a psychiatrist, which may also result in an alternative treatment advice
  • Safety screening before starting treatment
  • Embedding of esketamine in a broader depression treatment (e.g., alongside ongoing psychotherapy), in some circumstances temporarily fully at UMC Utrecht
  • Questionnaire-based effect and side-effect monitoring, with optional data use for research (P-TRD study)

Common questions

Who is eligible, and who is not?

Eligibility requires treatment-resistant depression: at least two antidepressants tried, one combined with an addition such as lithium or an atypical antipsychotic, i.e., at least three failed medication steps in the current episode. You cannot receive the treatment if you are pregnant, have a bipolar disorder diagnosis, have strongly elevated untreated blood pressure, aneurysmal vascular disease, a previous brain haemorrhage, or heart/vascular complaints in the past six weeks.

How does referral work?

Your GP or GGZ clinician refers you to UMC Utrecht; the referral is processed and assessed by the Advies- & aanmeldteam (weekdays 8:00-17:00, 088 755 6370, secretariaat33@umcutrecht.nl). You always first have a consultation (second opinion) with a UMC Utrecht psychiatrist, which can also lead to advice other than starting esketamine.

What does a session involve, and why can't I use the spray at home?

The medicine is always administered at UMC Utrecht because of the required checks and its consciousness-altering effects. You self-administer via a nasal spray pump with one of the professional caregivers with you each time; blood pressure is monitored. A session takes two to three hours plus 30-60 minutes preparation, twice a week in the first four to six weeks.

How long does the treatment last, and is it reimbursed?

Treatment is continued only if depressive symptoms improve, with the number of administrations reduced step by step; in the Netherlands it has been agreed the treatment lasts at most six months because long-term side effects are not yet clear. It is a registered treatment reimbursed by health insurers, provided the requirements on depression severity and prior treatments are met.

Looking at alternatives? St. Antonius Ziekenhuis (Nieuwegein/Utrecht) runs the same programme as hospital day treatment, and Altrecht (Utrecht) is also an ENC-NL centre. See enc-nl.nl and our Netherlands country guide.

Verification

This record was taken directly from an official registry or program list and is re-checked on a rolling cadence.

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