What are stimulant medicines?
Stimulant medicines are dexamphetamine (DEX) and methylphenidate (METH). Both DEX and METH stimulate the central nervous system (CNS) by increasing the activity of certain chemicals in the brain. METH may be sold under the brand names of Ritalin ®, Concerta ® or Attenta ® and is available in immediate release and sustained release formulations.
Why are they used?
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 brain damage.
What restrictions are there on the prescribing and dispensing of stimulant medicines?
In WA, the Stimulant Prescribing Code sets the criteria for the prescribing of stimulant medicines. The code outlines who can prescribe stimulant medicines, maximum doses that may be prescribed, and patient age limits and co-morbidities that may prevent the routine prescribing of stimulant medicines.
Stimulant medicines have legitimate therapeutic uses but also the potential for addiction or abuse. They are included in Schedule 8 of the Poisons Act 1964 and there are additional restrictions on the prescription and dispensing which apply to Schedule 8 medicines.
Who can prescribe stimulant medicines?
In WA, stimulant medicines may only be prescribed by specialist medical practitioners (psychiatrists, paediatricians, neurologists, thoracic medicine, rehabilitation or respiratory and sleep physicians) who are authorised by the Department of Health. A general practitioner (GP) may also be involved in the care of patients being treated with stimulant medicines, under the direction of the authorised specialist. GPs cannot initiate treatment with stimulant medicines.
What is the specialist’s role in prescribing stimulant medicines?
When an authorised specialist initiates treatment with stimulant medicines they are required to complete a Notification of Treatment Using Stimulant Medication form which is submitted to the Department of Health. The Notification form contains information on patient details, the condition being treated and medicine/s to be prescribed. Patients must sign the Notification to indicate their awareness that the information on the form will be forwarded to the Department of Health.
What is the role of the pharmacy in dispensing stimulant medicines?
All repeat prescriptions for stimulant medicines must be dispensed from the pharmacy that dispensed the original prescription. The repeats must be kept in the pharmacy between dispensing.
The pharmacist will use information on the prescription to determine when repeat supplies of stimulant medicines are able to be dispensed. If a patient requires a prescription before this date, the pharmacist must contact the prescriber before dispensing.
The pharmacy is also required to send information to the Department of Health, including patient name, details of the medicines dispensed, and prescribing doctor.
What if a repeat supply of stimulant medicine is required before the due date?
If a patient requires a prescription to be filled before the date that it is due to be dispensed, the pharmacist must contact the prescriber before dispensing. The pharmacist must ensure that the supply of stimulant medicines is appropriate for a patient and is in accordance with the prescriber’s recommendations.
What happens to the information collected by the Department of Health?
The Department of Health uses this information to ensure that stimulant medicines are prescribed and dispensed according to the law.
All the information that is collected is highly confidential. It is stored on a database in a secure area of the Department and can only be accessed by a small number of Departmental staff.
To access information held by the Department of Health a person may apply to the Director General under the Freedom of Information Act. There is no charge for personal information.
To find out more:
For more information on the prescribing and dispensing of stimulant medicines in WA see your health professional.
