Implementing psychedelic-assisted therapy: History and characteristics of the Swiss limited medical use program

This article describes the Swiss limited access program for psychedelic/3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy. The Swiss Federal Office of Public Health can issue authorizations for the limited medical use of otherwise prohibited substances. To be eligible, patients suffer from a mostly incurable disease, the prohibited substance can alleviate the suffering, and there are no alternative treatments, or such treatments have already extensively been used with insufficient outcome. The current program started in 2014 with two physicians. In 2024, there were approximately 100 physicians who held authorizations to treat 723 patients with MDMA (245 patients), lysergic acid diethylamide (130 patients), or psilocybin (348 patients). There were approximately 1660 psychedelic/MDMA-assisted treatments in 2024, with patients typically being treated 2-4 times with the respective substance within 12 months. Various aspects of the program, including its history, provider characteristics and setting, legal requirements, treatment cost, the role of professional societies, education and continuous formation, personal experience, patient characteristics, outcome, and adverse effects, are described and discussed relative to other recently established programs in Canada and Australia. Such information could be of interest to psychedelic-assisted therapy stakeholders, including professionals, patients, and regulatory bodies that are considering setting up similar restricted access programs.