An 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 approval number issued by the NSW Ministry of Health, regardless of which state or territory a prescription is issued in.
Note: An 'approval' is a reference to an authority under the Poisons and Therapeutic Goods Act 1966. An 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.
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 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 still apply for an approval to prescribe or supply a psychostimulant medicine to an individual patient when treating:
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.
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 General Practitioners (GPs) and 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.
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 therapeutic standards of what is appropriate in the circumstances.
Patients should also be informed of the risks and benefits of treatment and consent to therapy.
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:
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:
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:
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 are not authorised under the Poisons and Therapeutic Goods legislation to supply or prescribe psychostimulant medicines.
Applications for an 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:
A prescription for a Schedule 8 psychostimulant medicine is required to be endorsed with one of the following approval numbers* to be lawfully dispensed. This includes:
* 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.
** From 13 November 2023, 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.
