Prescribing psychostimulants to
treat ADHD or narcolepsy
Permit and notification requirements
2014.2
This document has been prepared by Drugs and Poisons Regulation (DPR) to assist medical practitioners to understand
permit and notification requirements associated with the prescribing of amphetamines and methylphenidate in Victoria. For
simplicity of reading, this document does not refer to all legislative requirements; merely those that are relevant to treatment
with the noted drugs. Documents dealing with other key legislative requirements may be found on the DPR website (at
www.health.vic.gov.au/dpcs/reqhealth). For full details, reference should be made to the Drugs Poisons and Controlled
Substances Act 1981 and Drugs Poisons and Controlled Substances Regulations 2006 (at www.legislation.vic.gov.au).
Paediatricians and psychiatrists
In recognition of the greater likelihood that paediatricians and psychiatrists will diagnose conditions for which
they wish to initiate treatment with amphetamine, dexamphetamine, lisdexamfetamine, methylamphetamine or
methylphenidate, there are exceptions to permit requirements. These exceptions do not apply to other medical
practitioners.
To determine whether a permit is required, please refer to the following five questions in the noted sequence.
Is the patient a drug-dependent person?

If you have reason to believe a patient is a drug-dependent person, you must obtain a Schedule 8
treatment permit before prescribing any of the noted drugs.
Are you initiating treatment of a patient diagnosed with attention deficit hyperactivity disorder (ADHD)?


A permit is not required to initiate treatment with the noted drugs BUT a permit must be obtained (or a
notification submitted by submitting the permit application form with section 3 completed) if the
prescribed quantity of medication represents treatment for a continuous period greater than 8 weeks.
Note: A single prescription with repeats might represent treatment for a continuous period greater than
8 weeks.
Do you intend to prescribe dexamphetamine, lisdexamfetamine or methylphenidate for a patient (less
than 18 years of age) for childhood ADHD for a period greater than 8 weeks?

A permit is not required - provided DPR is notified of the proposed treatment by submitting the permit
application form with section 3 completed.
Do you intend to prescribe any of the noted drugs for a patient (18 years or older) for ADHD for a period
greater than 8 weeks?

A permit must be obtained before the period of treatment of an adult exceeds 8 weeks. Permits will not
be issued in relation to amphetamine or methylamphetamine because these drugs are not registered for
use in Australia.
Have you been asked to prescribe one of the noted drugs for a patient who claims to be unable to
obtain a prescription from his/her regular prescriber?

An application for a permit must be submitted immediately if there is reason to believe that the
intended prescribing will contribute to a patient being treated for a continuous period greater than 8
weeks (including any preceding period of treatment by any prescriber/s).
. Department of Health

To avoid delaying treatment for a patient with a genuine therapeutic need, a medical practitioner is
authorised to continue treating the patient until the outcome of his/her permit application has been
determined but he/she must submit a permit application immediately – even if there is no intention to
prescribe on subsequent occasions.
Note:
 This provision is intended to prevent drug-seeking patients (with or without genuine documentation) from
obtaining multiple prescriptions from a clinic on the pretext that their regular treating practitioner is interstate,
overseas or otherwise unavailable.
 An explanation or documentation, which indicates that a prescription is required to provide ongoing
treatment for a chronic condition, should be sufficient to alert a general practitioner to the need to apply for a
permit.
 The previously noted exceptions to permit requirements are intended to enable paediatricians and
psychiatrists to initiate treatment for ADHD without first obtaining a permit and to continue treating the
patient without the administrative burden associated with renewing or amending permits.
Private prescriptions
PBS authority prescriptions for Schedule 8 poisons merely indicate that Medicare Australia will subsidise the
cost of the medication; medical practitioners must still obtain a Schedule 8 permit if required under Victorian
legislation.
Other medical practitioners (not paediatricians and psychiatrists)
Permit requirements for medical practitioners who are not paediatricians or psychiatrists are clear; it is an
offence to prescribe amphetamine, dexamphetamine, lisdexamfetamine, methylamphetamine or
methylphenidate without a permit – even on one occasion – unless one of the following exceptions applies.
General exceptions – prisons, residential aged care services, hospital inpatients
In circumstances where patients are confined and not personally managing their medications, the risk of
concurrent prescribing is significantly reduced. Accordingly, a permit is not required to prescribe Schedule 8
poisons for prisoners being treated in a prison, residents being treated in a residential aged care service and
patients receiving inpatient treatment in a hospital (not including day procedure centres).
Multi-practitioner clinics
In recognition of the fact that more than one medical practitioner at a clinic might be involved in the
management of some patients, each practitioner is not required to obtain a permit provided a valid permit is held
by one practitioner at the clinic and the prescribing is consistent with and does not exceed the permit limits or
conditions.
Note: To ensure compliance it is recommended that details of permits, including maximum dosage plus expiry
or cancellation dates, are prominently displayed within patient records.
Permit applications by general practitioners
Attention Deficit Hyperactivity Disorder
The department policy is that specialist involvement is necessary for the diagnosis and ongoing management of
all ADHD patients.
Page 2
Department of Health
General practitioners will generally only be issued with permits to prescribe dexamphetamine ,
lisdexamfetamine or methylphenidate where there is evidence of a specialist diagnosis and that a review with a
specialist has taken place within the last 12 months. Permits will not be issued in relation to amphetamine or
methylamphetamine because these drugs are not registered for use in Australia.
Narcolepsy
The department policy is that an initial diagnosis of narcolepsy must involve a respiratory physician or a
specialist in sleep disorders.
A general practitioner will generally not be issued with a permit unless the application indicates that the
physician or specialist has been consulted and endorses the treatment.
The department considers that, once narcolepsy is diagnosed, ongoing treatment by a general practitioner is
generally appropriate without further reference to the physician or specialist, provided other risks to patient
safety are not evident. Permits will not be issued in relation to amphetamine or methylamphetamine because
these drugs are not registered for use in Australia.
Permit application forms
Permit application forms and notification forms may be submitted online or downloaded from the DPR website
(at www.health.vic.gov.au/dpcs/reqhealth).
For further information
Department of Health (DH)
Drugs and Poisons Regulation,
GPO Box 4541
Melbourne 3001
Tel: 1300 364 545
Fax: 1300 360 830
Email: dpcs@health.vic.gov.au
Web: www.health.vic.gov.au/dpcs
Authorised and published by the Victorian Government, 50 Lonsdale St, Melbourne.
To receive this publication in an accessible format phone Drugs and Poisons Regulation on 1300 364 545 or
forward an Email to dpcs@health.vic.gov.au
February 2014
Page 3
Department of Health