Changes to prescribing rules for ADHD stimulant medicines took effect on 1 February, widening who can assess, diagnose and start people on treatment.

Previously, general practitioners and nurse practitioners could prescribe ADHD medicines only with a written recommendation from a paediatrician or psychiatrist, or after a specialist had initiated treatment. Under the updated rules, vocationally registered specialist GPs and nurse practitioners working within their area of practice can start stimulant medicines for adults aged 18 and over who have been diagnosed with ADHD.

“If you are seeking an ADHD assessment, you do not need to do anything differently from 1 February. Your general practice is still your first port of call as they will know what services are available in your area,” said Dr Jin Russell, Chief Clinical Advisor Child and Youth. She said the changes are about building the specialist workforce and pathways needed to support safe, thorough assessments, adding that services will not be available everywhere overnight and not every GP will take this up.

GPs and nurse practitioners with a special interest in ADHD may choose to offer assessments. The Ministry notes ADHD assessment is complex, typically taking one to two hours and sometimes spread over multiple appointments. Costs will depend on the service, local funding arrangements, and time required for assessment and follow‑up.

Under the new rules, GPs and nurse practitioners can prescribe the publicly funded stimulant medicines currently available: methylphenidate, dexamfetamine and lisdexamfetamine.

Supply constraints remain a factor. “Global shortages are ongoing due to high demand and limited manufacturing capacity,” Dr Russell said. Pharmac is actively managing supply and looking at alternative brands and treatments to support increased demand.