Approval from NSW Health is required to prescribe or supply Schedule 8 (S8) psychostimulant medicines dexamfetamine, lisdexamfetamine, or methylphenidate.
In NSW, a pharmacist cannot dispense these medicines unless the prescription includes a valid NSW Health approval number. This requirement applies regardless of the state or territory in which the prescription is issued.
Note: A NSW Health approval is an authorisation under the Poisons and Therapeutic Goods Act 1966. This approval is not the same as a PBS authority which allows access to a medicine at a subsidised cost.
Psychiatrists, paediatricians, and neurologists are authorised under a class authority to prescribe or supply psychostimulant medicine for the treatment of attention deficit hyperactivity disorder (ADHD) in a non-drug dependent person. This means that in most cases these specialists will not need to apply for approval for an individual patient.
The class authority can be used to prescribe up to a maximum daily dose of:
The Class authority to prescribe psychostimulants replaces the general authority (CNS or S28c) held by psychiatrists, paediatricians, or neurologists.
Psychiatrists, paediatricians, and neurologists must apply for individual patient approval to prescribe or supply a psychostimulant medicine to treat:
Psychiatrists, paediatricians, or neurologists practising outside NSW can use the class authority to prescribe to patients who have their psychostimulant medicine dispensed by a NSW pharmacy.
Psychiatrists, paediatricians, or neurologists intending to prescribe a psychostimulant medicine for indications other than ADHD must apply for individual patient approval.
The NSW Government has introduced reforms to authorise GPs to prescribe S8 psychostimulant medicines to people with ADHD. Applications to obtain a general authority as a continuation prescriber are now open.
For more information and how to apply, see ADHD in general practice and Expanding access to attention deficit hyperactivity disorder (ADHD) management - information for continuation prescribers.
A small number of continuation GP prescribers with additional specific and accredited training can diagnose ADHD and initiate medicines where appropriate. These GPs are referred to as endorsed prescribers.
All other specialists (such as respiratory and sleep physicians, palliative care physicians, rehabilitation physicians) must apply for individual patient approval to prescribe or supply a psychostimulant medicine.
All other registered medical practitioners, including advanced trainees in relevant medical specialties, are required to apply for individual patient approval to prescribe a psychostimulant medicine.
In most cases, these applications will only be approved where the applicant is in a patient co-management or transfer of care arrangement with a relevant medical specialist.
NSW Health will no longer issue ODP endorsements. This change follows the introduction of the endorsed prescriber pathway as part of the NSW ADHD in general practice reforms, and which will replace the ODP pathway.
For further details about the reforms and updated prescribing pathways, please visit the NSW ADHD in general practice webpage.
Nurse practitioners are not authorised under the Poisons and Therapeutic Goods legislation to supply or prescribe psychostimulant medicines.
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Applications for approval to prescribe or supply a psychostimulant medicine can be submitted via SafeScript NSW or via submission of an Application for Approval to prescribe or supply a Schedule 8 psychostimulant.
Submitting applications via SafeScript NSW allows prescribers to monitor their application progress online and to receive real-time approval in many cases. Prescribers are notified immediately if:
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A prescription for a S8 psychostimulant medicine must include one of the following approval numbers* to be lawfully dispensed:
Requirements for issuing these prescriptions can be found at Schedule 8 psychostimulant prescriptions.
* This approval is distinct from, and independent of, any authority from Services Australia, which is for the purpose of subsidising the cost of medicines for patients under the Pharmaceutical Benefits Scheme (PBS). For more information, see Authority PBS Prescription.
**CNS or S28c authority holders that are:
Note: Prescriptions endorsed with reference number “CNS" or “S28c" will remain valid for dispensing, unless expired or cancelled. For more information, see Authority (CNS orS28c) to prescribe or supply psychostimulant medicines.
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When prescribing psychostimulant medicines, prescribers are expected to consider the patient's individual circumstances and balance the risks and benefits of treatment. This is especially important when considering prescribing combination psychostimulant therapy. Treatment decisions should be informed by available evidence, published clinical guidelines, and recognised therapeutic standards.
Patients should also be informed of the risks and benefits of treatment and consent to therapy.
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