Stimulant medicines

Stimulant medicines stimulate the central nervous system (CNS) by increasing the activity of certain chemicals in the brain. Dexamfetamine, lisdexamfetamine and methylphenidate are all stimulant medicines.

Lisdexamfetamine may be sold under the brand name of Vyvanse^®.

Methylphenidate is available in immediate release and sustained release formulations and may be sold under the brand names of:

• Ritalin^®
• Concerta^®
• Ritalin LA^®

Stimulant medicines are used in the treatment of attention deficit hyperactivity disorder (ADHD) and narcolepsy (a sleep disorder). They may also be used in the treatment of depression or acquired brain injury.

Who can prescribe stimulant medicines?

In Western Australia (WA), stimulant medicines are usually initiated by a medical practitioner who holds specialist registration such as:

• psychiatrists
• paediatricians
• neurologists
• rehabilitation doctors
• respiratory doctors
• sleep medicine doctors.

Some general practitioners (GPs) in WA have undertaken additional training and are authorised to diagnose ADHD and start treatment with stimulant medicines, for eligible patients, aged 10 years and over.

As part of shared care with the patient’s specialist, other GPs or nurse practitioners may be able to prescribe continuing stimulant medication for a patient, once it has been initiated by an approved stimulant prescriber. You will still need regular review appointments with your specialist as part of this arrangement.

You should speak to your specialist doctor about whether it is suitable for your GP to provide prescriptions between specialist appointments.

What restrictions are there on the prescribing and dispensing of stimulant medicines?

In WA, the Monitored Medicines Prescribing Code (the Code) sets the criteria for the prescribing of stimulant medicines. To ensure patient safety, the Code outlines:

• who can prescribe stimulant medicines
• maximum doses that may be prescribed
• when prescribers require authorisation to manage the risk of prescribing stimulant medicines for patients with complex health conditions.

Stimulant medicines have legitimate therapeutic uses but also carry the potential for addiction or misuse. For this reason, they are classified as Schedule 8 medicines, also known as ‘controlled drugs’. As with all Schedule 8 medicines, additional restrictions apply to their prescribing and dispensing. 

Why is my doctor no longer able to prescribe my stimulant medicine?

To help reduce the risk of potential harm, there are restrictions on the supply of stimulant medications. These restrictions apply if you:

• have a specified medical condition such as psychosis, bipolar disorder or drug dependence
• are receiving medication to treat a substance use disorder
• have been oversupplied with Schedule 8 medicines.

These restrictions do not  prevent you from accessing the most appropriate stimulant medication. However, they mean your specialist has to apply to the Department for approval, before they can commence prescribing stimulant medication for you. Additionally, you may be required to do a urine drug screen. Your consent is required for the specialist to send the information to the Department.

It is best to discuss the matter with your specialist. They can get in touch with the Department who will assist them to get the best possible outcome.

What is the role of the pharmacy in dispensing stimulant medicines?

All paper-based and computer-generated repeat prescriptions for stimulant medicines must be held and dispensed in the same pharmacy, where the original prescription was dispensed. Fully electronic stimulant repeats (with an electronic token) do not need to be dispensed at the same pharmacy.

If a transfer of your repeat prescription is required, please speak to your pharmacist who will be able to arrange for the transfer of your prescription to a pharmacy you have nominated. 

The pharmacist cannot return the paper-based prescription repeat to your, or to an agent or carer. The pharmacist must send the repeat prescription directly to your nominated pharmacy. 

What if a repeat supply of stimulant medicine is required before the due date?

If you require a prescription to be filled before the due date, before they can dispense your repeat, the pharmacist must contact the prescriber for approval to supply the repeat before the due date.

The pharmacist must ensure that the supply of stimulant medicines is appropriate for a patient and is in accordance with the prescriber’s recommendations.

Receiving supplies of stimulant medicines, beyond your prescribed dose, may result in your prescriber requiring authorisation to continue to prescribe and restrictions on future supplies you receive from the pharmacy. 

Can I get my interstate prescription for stimulants dispensed in WA?

Interstate prescriptions for stimulant medicines can be dispensed at any pharmacy in WA. Interstate prescribers are required to comply with the prescribing requirements in WA. 

Pharmacists may need to contact the prescriber to confirm the authenticity of the prescription.

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This publication is provided for education and information purposes only. It is not a substitute for professional medical care. Information about a therapy, service, product or treatment does not imply endorsement and is not intended to replace advice from your healthcare professional. Readers should note that over time currency and completeness of the information may change. All users should seek advice from a qualified healthcare professional for a diagnosis and answers to their medical questions.