​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​​An authority/approval from the NSW Ministry of Health is required to prescribe or supply dexamfetamine, lisdexamfetamine, or methylphenidate.

A pharmacist in NSW cannot dispense a prescription for psychostimulant medicine unless the prescription shows an authority/approval number issued by the NSW Ministry of Health, regardless of which state or territory a prescription is issued in.

Note: An authority/approval issued to a prescriber by the NSW Ministry of Health is separate to the authority required from Services Australia for a patient to receive a Commonwealth PBS subsidised medicine.

NSW Health are updating the terminology currently used from 'authority' to 'approval.' In SafeScript NSW an approval is a reference to an authority issued under the Poisons and Therapeutic Goods Act 1966.

Information on the prescribing of a psychostimulant medicine is available on this page.

​On this page

Who can prescribe a psychostimulant medicine

Specialist prescri​​​bers

Psychiatrists, paediatricians, and neurologists 

​​Trea​tment of Attention Deficit Hyperactivity Disorder (ADHD)

From 13 November​ 2023 psychiatrists, paediatricians, and neurologists are authorised under a class authority to prescribe or supply psychostimulant medicine for the treatment of ADHD in a non-drug dependent person. This means that in most cases, psychiatrists, paediatricians, and neurologists will not need to apply for an authority/approval for an individual patient.

The class authority can be used to prescribe up to a maximum daily dose of:

  • dexamfetamine 50mg
  • lisdexamfetamine 70mg
  • methylphenidate 108mg.

The Class authority to prescribe psychostimulants replaces the general authority (CNS or S28c) held by psychiatrists, paediatricians, or neurologists.

Psychiatrists, paediatricians, and neurologists must still apply for an authority/approval to prescribe or supply a psychostimulant medicine to an individual patient when treating:

  • ​drug-dependent patients
  • indications other than ADHD
  • ADHD with doses exceeding dexamfetamine 50mg, or lisdexamfetamine 70mg, or methylphenidate 108mg.

Psychiatrists, paediatricians, or neurologists practicing outside NSW can use the class authority to prescribe to patients who have their psychostimulant medicine dispensed by a NSW pharmacy.

​Indications other than ADHD

Psychiatrists, paediatricians, or neurologists wanting to prescribe a psychostimulant medicine for indications other than ADHD must apply for individual patient authority/approval. 

Other specialist prescribers

All other specialists (such as; respiratory and sleep physicians, palliative care physicians, rehabilitation physicians) must apply for individual patient authority/approval to prescribe or supply a psychostimulant medicine​.​  ​​​

​Other registered medica​l practitioners co-managing patients with a specialist prescrib​​er

All other registered medical practitioners including General Practitioners (GPs) and advanced trainees in relevant medical specialties, are required to apply for individual patient authority/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. ​

​Combination pharmacotherapy

When ​prescribing psychostimulant medicines, prescribers are expected to consider their patient's individual circumstances and balance the risks and benefits of treatment. This is especially important when considering prescribing combination psychostimulant therapy. Prescribers are advised to consider the available evidence, published clinical guidelines and recognised therapeuti​c standards of what is appropriate in the circu​mstances. 

Patients should also be informed of the risks and benefits of treatment and consent to therapy. 

​Other designated prescribers (ODPs) treating ADHD

​Certain medical practitioners can be granted ‘other designated prescriber (ODP)' status to prescribe psychostimulant medicines under certain conditions. 

ODPs are required to apply for an individual approval for each patient and are generally limited to prescribing psychostimulant medicines to children with ADHD: 

  • for dexamfetamine and methylphenidate, patients aged 4 to 17 years (inclusive), or for lisdexamfetamine, patients aged 6 to 17 years (inclusive), and
  • for daily doses that do not exceed:
    • dexamfetamine 50mg
    • lisdexamfetamine 70mg
    • ​methylphenidate 108mg.

Generally, ODP status is considered for certain medical practitioners including:

  • advanced trainees in community paediatrics or child psychiatry, psychiatry, or neurology, working under the supervision of a specialist, or​​​​​
  • general practitioners with paediatric training working in rural or remote areas, or
  • general practitioners in a predominantly paediatrically orientated practice.

If you would like to be considered for ODP status, please submit a request to MOH-PharmaceuticalServices@health.nsw.gov.au. Your submission should include:

  • a cover letter outlining why you should be considered for ODP status (such as, you practice in a remote geographical location/area of need)
  • an up-to-date resume that details your qualifications and your experience in the treatment of ADHD in children and adolescents
  • a letter from a relevant specialist (child psychiatrist/paediatrician) supporting your application and agreeing to offer you clinical support where needed.

Please note a general practitioner or other registered medical practitioner does not need to be endorsed as an ODP to prescribe psychostimulant medicines. For more information see Other registered medical practitioners co-managing patients with a specialist prescriber​.

Nurse p​​ractitioners​

Nurse practitioners are not authorised und​er the Poisons and Therapeutic Goods legislation to supply or prescribe psychostimulant medicines.​​​

How to apply for an individual patient authority/approval to prescribe a psychostimulant medicine​

Applications for an authority/approval to prescribe or supply a psychostimulant medicine should 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 will be notified immediately if: 

  • an approval is required​​
  • the application is automatically approved
  • the application needs to be reviewed by NSW Health.

​Prescription requirements for psychostimulant medicines

A prescription for a Schedule 8 psychostimulant medicine is required to be endorsed with one of the following authority/approval numbers* to be lawfully dispensed. This includes:

  • CA2023 - for use by psychiatrists, paediatricians and neurologists prescribing under the conditions of the class authority
  • Axxxxxxx or AU​​xxxxxxx - unique number that may be specific for a prescriber or specific for a patient      
  • CNSxxxxxxx  or S28​​cxxxxxxx - unique prescriber approval previously issued to a prescriber by the Ministry of Health)**.

* This authority/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.

** From 13 November 2023, CNS or S28C authority holders that are:

  • psychiatrists, paediatricians, or neurologists must start using the class authority where applicable or otherwise apply for individual patient approval
  • medical practitioners who have been issued an alternative authority with reference number prefix "Axxxxxxx", must start using this number to endorse prescriptions for psychostimulants. The conditions stated in that authority must be followed.

NOTE: Current prescriptions endorsed with reference number “CNS" or “S28c" will remain valid for dispensing until 30 June 2024, unless expired.

Current as at: Thursday 21 March 2024
Contact page owner: Pharmaceutical Services