An approval from the NSW Ministry of 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 an approval number issued by the NSW Ministry of Health. This requirement applies regardless of the state or territory in which the prescription is issued.
Note: An 'approval' is a reference to an authority under the Poisons and Therapeutic Goods Act 1966. This approval issued to a prescriber by the NSW Ministry of Health, is separate from the PBS authority issued by Services Australia that allows a patient to access a PBS-subsidised medicine.
On this page
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Who can prescribe a Schedule 8 psychostimulant medicine
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How to apply for an individual patient approval
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Prescription requirements for psychostimulant medicines
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Combination pharmacotherapy
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Related links
Who can prescribe a Schedule 8 psychostimulant medicine
Specialist prescribers
Psychiatrists, paediatricians, and neurologists
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, psychiatrists, paediatricians, and neurologists will not need to apply for an 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 apply for individual patient approval to prescribe or supply a psychostimulant medicine to treat:
- 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.
Psychiatrists, paediatricians, or neurologists wanting to prescribe a psychostimulant medicine for indications other than ADHD must apply for individual patient approval.
General practitioner continuation prescribers
The NSW Government has introduced reforms to authorise general practitioners (GPs) to prescribe S8 psychostimulant medicines to people with ADHD. Applications to obtain a general authority as a continuation prescriber are now open.
Other specialist 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.
Other registered medical practitioners co-managing patients with a specialist prescriber
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.
Other designated prescribers (ODPs) treating ADHD
A medical practitioner can apply to the Pharmaceutical Services Unit to become an “Other Designated Prescriber" (ODP). Once granted, ODPs can then apply for approval to prescribe or supply Schedule 8 psychostimulant medicines under certain conditions without the support of a relevant Ahpra registered specialist.
ODP status is generally only 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.
ODPs are still 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.
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 apply for an individual patient approval to prescribe psychostimulant medicines. For more information see Other registered medical practitioners co-managing patients with a specialist prescriber. |
Nurse practitioners
Nurse practitioners are not authorised under the Poisons and Therapeutic Goods legislation to supply or prescribe psychostimulant medicines.
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How to apply for individual patient approval
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:
- an approval is required
- the application is automatically approved
- the application needs to be reviewed by NSW Health.
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Prescription requirements for psychostimulant medicines
A prescription for a S8 psychostimulant medicine must include one of the following approval numbers* to be lawfully dispensed:
- CA2023 - for use by psychiatrists, paediatricians and neurologists prescribing under the conditions of the
class authority
- Axxxxxx or AUxxxxxx - unique number that may be specific for a prescriber
or specific for a patient
- CNSxxxxxx or S28cxxxxxx - unique prescriber approval previously issued to a prescriber by the Ministry of Health)**.
- GACPxxxxxxx - unique number issued to a specific continuation prescriber
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:
- 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 "Axxxxxx", must use this number to endorse prescriptions for psychostimulants. The conditions stated in that authority must be followed.
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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Combination pharmacotherapy
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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