A nasal spray based on ketamine should be made available on the basic health insurance package to treat people with depression, the Dutch healthcare institute has advised.

Eketamine has been shown to be effective in combination with other anti-depressants in three out of five recent studies and has been approved by both the European Medicines Agency and its US equivalent, the FDA.

The National Health Care Institute says the drug should always be administered by a doctor because it is potentially addictive and can cause hallucinations at higher doses. It is the first psychedelic drug to be approved for medical use to treat depression.

The institute had hoped that the drug would be included in the compulsory insurance package at the start of this year, but the public health ministry and Leiden-based pharmaceutical company Janssen are still negotiating the price. The agency estimates the cost to be more than €10,000 per patient per year.

It said eketamine should offered to adults who had already been treated with at least three other types of antidepressant without success.

Bart Groeneweg, of the Depression Association (Depressie Vereniging), said he was pleased with the institute’s recommendation. ‘Around 20% of people with depression don’t recover,’ he said. ‘These people often feel there is no way out. This gives new hope to this group of patients.’