Policy Announcement - update on requirements to prescribe the Schedule 8 psychostimulant medicines dexamfetamine, lisdexamfetamine and methylphenidate

The NSW Ministry of Health has updated the requirements to prescribe Schedule 8 psychostimulant medicines (dexamfetamine, lisdexamfetamine and methylphenidate). These changes recognise the scope of practice and expertise of psychiatrists, paediatricians and neurologists and are intended to reduce burden on patients, carers and families.

Key changes

• From 13 November 2023 psychiatrists, paediatricians and neurologists are authorised to prescribe or supply a Schedule 8 psychostimulant medicine under a class authority (see https://www.health.nsw.gov.au/pharmaceutical/Documents/authority-class-of-persons.pdf ) issued by the Ministry of Health. These prescribers are required to include the class authority number ‘CA2023’ on prescriptions issued for a Schedule 8 psychostimulant medicine. The class authority applies when prescribing:

• to a patient who is not drug dependent, and
• for the treatment of attention deficit hyperactivity disorder (ADHD), and
• up to a maximum daily dose of:

o dexamfetamine 50mg

o lisdexamfetamine 70mg

o methylphenidate 108mg.

An individual patient application is required only when prescribing falls outside the conditions of the class authority.

• The general authority (CNS/S28c) will no longer be issued.
  • If you are a psychiatrist, paediatrician or neurologist issued with a CNS or S28c authority by Ministry of Health, you are requested to use the class authority number ‘CA2023’ on prescriptions for a Schedule 8 psychostimulant medicine instead.
  • If you are not a psychiatrist, paediatrician or neurologist but a holder of a CNS or S28c authority, you will be contacted by NSW Health to discuss alternatives.

• If you have been issued an authority by NSW Health as an ‘Other Designated Prescriber (ODP)’ you may continue to apply for individual patient approval for the treatment of ADHD for patients aged 4-17 years at daily maximum doses of dexamfetamine 50mg, or lisdexamfetamine 70mg, or methylphenidate 108mg.

• All other medical practitioners must obtain an individual patient approval to prescribe a Schedule 8 psychostimulant medicine.

Requirements for compliance

• An authority (approval) number must be included on all prescriptions for Schedule 8 psychostimulant medicines to be lawfully dispensed by a pharmacist.

*an approval is reference to an authority issued under section 29 of the Poisons and Therapeutic Goods Act 1966

Applying for individual patient approval

Applications for approval to prescribe Schedule 8 psychostimulant medicines can now be submitted online via SafeScript NSW (https://www.safescript.health.nsw.gov.au/health-practitioners), where in some cases a real-time approval may be issued.

To manually submit an application to the Ministry of Health, access the updated form Application for approval to prescribe or supply a Schedule 8 psychostimulant from the Pharmaceutical Services website at https://www.health.nsw.gov.au/pharmaceutical/doctors/pages/application-forms.aspx

Further information

For more information visit Prescribe a psychostimulant (https://www.health.nsw.gov.au/pharmaceutical/doctors/Pages/prescribe-psychostimulant.aspx), or contact Pharmaceutical Services via email at MOH-PharmaceuticalServices@health.nsw.gov.au.