Medicines for ADHD in adults

Medicine is used to support other changes to your lifestyle and behaviour. ADHD is best managed with a combination of treatments including medicine, lifestyle changes, psychotherapy, education and knowledge.

Treatment is provided by a mental healthcare professional experienced in working with people with ADHD. It includes:

• education to help you understand how to work with your brain, rather than expecting it to work like someone else’s
• cognitive behavioural therapy (CBT)
• social skills training
• support for any drug or alcohol addiction
• treatment for any related conditions or issues caused by unrecognized ADHD
• helping you get support from friends or family who can be encouraging rather than critical or controlling.

Read more about how ADHD is treated.

Stimulant medicines (methylphenidate, dexamfetamine and lisdexamfetamine) are more complex than other medicines because of special prescribing, dispensing and funding rules that apply to them.

Stimulant medicines are controlled drugs

In Aotearoa New Zealand methylphenidate, dexamfetamine and lisdexamfetamine are classed as controlled drugs, which means they're carefully monitored and regulated to make sure they're used safely. This is because they affect the brain and can be addictive or misused if not taken properly. Because of this, prescribers need to follow special rules when prescribing them, and pharmacies must keep records when they dispense them.

• You can get a prescription with repeats that cover up to 3 months, depending on your prescriber’s decision, but pharmacies can only dispense 30-day supplies at a time.
• You need to pick up the medicine within 7 days of it being dispensed, or the prescription may expire or require reauthorization.
  
  

Stimulant medicines are funded under a Special Authority

In Aotearoa New Zealand methylphenidate, dexamfetamine and lisdexamfetamine are funded under a Special Authority, for people who meet the criteria.

• The term 'Special Authority' refers to a specific kind of approval needed for funding certain subsidised medicines by Pharmac.
• Pharmac is the government agency in New Zealand that decides which medicines and medical devices are publicly funded. Pharmac uses this process to ensure medicines are funded for people who will benefit most from the treatment. Read more about Special Authority.

Who can apply? Applications for Special Authority for stimulant medicines used to treat ADHD can be made by specialists such as a paediatrician or psychiatrist, who can apply directly. General practitioners (GPs) or nurse practitioners can also apply, provided they have a written recommendation from a paediatrician or psychiatrist.

Does the Special Authority expire? For stimulant medicines used to treat ADHD, the Special Authority does not expire, as the renewal criteria were removed in 2024, making the approval valid for the patient’s lifetime.

When you start ADHD medicines, your healthcare provider will closely monitor how well it’s working and whether you have any side effects. This monitoring helps make sure the medicine is safe and effective for you.

It's important to have regular check-ups with your healthcare provider to see how well your treatment is working and how the medicine affects your symptoms. It's also important to monitor side effects, such as changes in appetite, sleep, mood, or heart rate. Your healthcare provider will adjust the dose or medicine if needed to find the right balance between benefits and side effects.

ADHD medicines are usually taken every day but may be paused or adjusted based on how your symptoms change over time. It's important to have regular reviews with your healthcare provider to decide if your medicines should continue, change, or stop. Your healthcare provider may suggest you try going off the medicine (for a few days or up to 2 weeks) every now and then to see how well you can manage without medicine. If problems occur, the medicine can be re-started. It's important that you don't start or stop your medicine unless you have been told to by your healthcare provider.

Important: Medication is just one part of managing ADHD, so it’s often combined with other treatments like therapy and lifestyle changes.