From January 2026, patients in Czechia with severe depression or other serious mental health conditions may be able to receive psilocybin therapy, the active ingredient in magic mushrooms, under strict medical supervision.

The Ministry of Health has finalized a decree specifying how the treatment can be used, following a Senate-approved amendment to legalize medical psilocybin earlier this year.

The therapy is intended for patients whose symptoms have not responded to conventional treatments such as antidepressants. Outgoing Health Minister Vlastimil Válek confirmed it will also be available for cancer-related depression and sudden worsening of other serious neuropsychiatric conditions, provided its use is backed by scientific evidence.

The decree limits prescribing and dosing: only psychiatrists can administer psilocybin, treatments must be supervised by specialists, and patients can receive a maximum of three doses per month, with no more than 75 grams in total.

A single dose cannot exceed 35 mg or 0.4 mg per kilogram of body weight. Authorities say psilocybin is low in toxicity, non-addictive, and generally safe under medical supervision, though unsupervised use can be dangerous.

Dr. Rita Kočárová, a psychologist and researcher in psychedelic care, emphasizes that legal approval alone is not enough. “Treatment with psychedelics requires expertise, a safe setting, preparation, and follow-up integration,” she says. Kočárová is helping train professionals and develop guidelines through institutions such as Beyond Academy and Beyond Institute, drawing on international examples from Canada, Switzerland, and Australia.

Access will initially be limited, with insurance coverage still under negotiation. Jiří Horáček, director of the National Institute of Mental Health (NUDZ), said restricting treatment to those who can pay out-of-pocket would be “unacceptable.”

Sessions can cost tens of thousands of crowns and last at least six hours, usually with two qualified therapists present. Currently, only a few dozen specialists in the Czech Republic are trained to provide the therapy.

Experts describe psilocybin as offering patients a new perspective on depression. Addiction specialist Aleš Kuda says it allows patients to see “beyond the blindfold” of their illness. During sessions, patients may experience altered states of consciousness, heightened emotional awareness, and profound personal insights. Jiří Horáček notes that the antidepressant effect typically lasts two to three months.

Minister Válek highlights that Czechia is the first European country to legalize psychedelic therapy under legislation, though questions about funding and broader access remain.

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