Medical Access and Reimbursement in Spain

Psilocybin and psilocin are listed in Spain's psychotropic-control framework. Patient access should be described as clinical-trial or special-situations only, with no public evidence of a standing national compassionate-use programme. # # #

MDMA is controlled in Spain. The historically important Madrid PTSD pilot does not create current routine access or reimbursement, and any lawful use remains research or exceptional-access based. # # #

Spravato is EU-authorised and listed in Spain. BIFIMED shows public financing from 1 November 2022 for adults aged 18-74 with severe TRD who have failed at least three antidepressant strategies, including one combination or augmentation strategy. The psychiatric-emergency indication is not publicly financed. # # #

Racemic ketamine is authorised as an injectable anaesthetic medicine, not as an antidepressant. Psychiatric use is therefore off-label, and no national depression-specific reimbursement route equivalent to Spravato was identified. # #

DMT is listed in Spain's controlled psychotropic framework. Research on DMT-related mechanisms exists historically through the ayahuasca line, but this does not translate into routine medical access or reimbursement. # #

5-MeO-DMT/mebufotenin should be framed as investigational in Spain. Barcelona-linked participation in GH001 research is a scientific signal, not an authorised or reimbursed treatment pathway. # #

No public evidence was identified for routine authorised ibogaine treatment or reimbursement in Spain. Any claim of access should be verified against AEMPS permissions and Spanish controlled-substance rules. # #

Ayahuasca is not an authorised medicine in Spain and recent court discussion should not be read as national medical legalisation. The safest access description is legally contested non-medical use, with no reimbursement pathway. # #

Mescaline is listed in Spain's psychotropic controls. No authorised medical access or reimbursement pathway was identified. #

2C-family phenethylamines should be treated as controlled or unauthorised in Spain for medical access purposes. No routine clinical pathway or reimbursement route was identified. # #