ADHD medications dispensed 2004–05 to 2023–24

Introduction

ADHD in Australian

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition that is characterised by problems with attention and concentration or hyperactivity and impulsiveness, or a mixture of symptoms (American Psychiatric Association, 2013). The symptoms of ADHD, which can negatively affect a person’s schooling, work and relationships, often begin in childhood and may continue throughout adulthood (Healthdirect 2024b).

In recent years, there has been a growing awareness and discussion on the impacts of ADHD on individuals and society, accompanied by increasing rates of diagnosis and pharmacological treatment (Senate Community Affairs References Committee 2023). There are also concerns that the current trends are indicative of overdiagnosis, which may also have negative impacts on individuals (Kazda et al. 2023).

This article provides an overview of the medicines listed on the Pharmaceutical Benefit Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) for ADHD treatment, and trends in the dispensing of those medicines during the period 2004–05 to 2023–24. Further information on PBS and RPBS data can be found in the technical notes section of this report, and the data source section of the Mental health prescriptions online report (AIHW 2025).

Medications commonly prescribed for ADHD

There are two types of medications listed on the PBS for treatment of ADHD. Psychostimulants are the most widely prescribed and are usually the first-line treatment for ADHD. There are three psychostimulants listed on the PBS:

• Dexamfetamine
• Methylphenidate
• Lisdexamfetamine

The other type of medicines are non-stimulants which may be prescribed if stimulants are not effective, or are unsuitable due to other medical conditions or side effects:

• Atomoxetine
• Guanfacine

Both medication types are dispensed in various dosages and as either immediate release or modified-release (long-acting) tablets or capsules. As psychostimulants are potentially addictive, their prescription and supply are highly regulated (Department of Health and Aged Care 2025b; DUSC 2018). Formal diagnosis of ADHD and initial pharmacological treatment in Australia is mostly restricted to Psychiatrists or Paediatricians, although other clinicians such as General Practitioners may have a role in ongoing management and prescribing for stabilised conditions, depending on the state or territory (DUSC 2018).

The blood pressure-lowering medication clonidine may also be prescribed as a second-line treatment for children with ADHD for symptoms such as aggression or sleep disturbance (Healthdirect 2024a). Clonidine has not been included in this analysis as it has an unrestricted listing on the PBS so it cannot be determined conclusively if a prescription was for treatment of ADHD.

The timeline of when each medication was listed on the PBS, and key changes to listing criteria and authority requirements, are outlined in Figure 1.

Figure 1: PBS listing timeline for ADHD treatment medications

Source: (DUSC 2023; Senate Community Affairs References Committee 2023).

Trends over time

During 2023–24 there were over 4.6 million prescriptions for ADHD-related medications dispensed to just under 600,000 patients (an average of 8 prescriptions per patient). Of those prescriptions, 87% were for psychostimulants. This proportion reflects the use of psychostimulants as a first-line treatment, and PBS criteria that restricts prescriptions of non-stimulants to patients 6–18 years or those continuing treatment into adulthood.

The population rate for ADHD prescriptions increased 11-fold from 2 patients per 1,000 population in 2004–05 to 22 (2% of the Australian population) in 2023–24 (Figure 2). Over the same period the average yearly number of prescriptions per patient increased from 5 to 8, and the prescription rate increased from 10 to 172 prescriptions per 1,000 population. Much of the increase in the population rate occurred in the years from 2018–19 onwards. The population rate increased from 2 to 8 people per 1,000 population during the 14 years from 2004–05 to 2018–19 and from 8 to 22 in the 5 years from 2018–19 to 2023–24.

Trends over time were partly influenced by changes to the PBS, including listing of new medications and changes to PBS eligibility criteria. Examples of these are:

• The decline in prescriptions and patients for dexamfetamine from 2004–05 to 2010–11 coincided with the listing of methylphenidate in August 2005. Increases in methylphenidate dispensing offset the drop for dexamfetamine, resulting in an overall increase in ADHD prescriptions during those years.
• The jump in prescriptions and prescription rates from 2011–12 to 2012–13 coincides with the addition of data for prescriptions under the co-payment threshold from 1 April 2012. Prior to this the PBS/RPBS data only include subsidised prescriptions.
• Increases for lisdexamfetamine from 2020–21 onwards and for methylphenidate from 2022–23 to 2023–24 coincided with the expansion of the PBS listings for these psychostimulant medicines to include adults with a retrospective diagnosis.
• The non-stimulant guanfacine has had steady increases in prescription and population rates since listing on the PBS on 1 March 2019.

Figure 2: PBS prescriptions dispensed for treatment of ADHD, 2004–05 to 2023–24

Sex and age group

Males have consistently had higher overall prescription rates for ADHD-related medications compared with females, but the gap has closed during the past 5 years, particularly for the psychostimulants dexamfetamine and lisdexamfetamine (Figure 3). In the 5 years from 2018–19 to 2023–24, the population rate for males (all ADHD medications) more than doubled from 11 to 26 per 1,000 population, whereas the population rate for females increased 5-fold from 4 to 19.

Psychostimulant methylphenidate prescriptions were the most dispensed ADHD medication for people overall and males each year from 2007–08 to 2023–24. For females, methylphenidate was the most dispensed ADHD prescription each year from 2007–08 until 2022–23 when it was overtaken by lisdexamfetamine.

Figure 3: PBS prescriptions for dispensed for treatment of ADHD, by patient sex, 2004–05 to 2023–24

The higher population and prescription rates for males overall (all age groups) is due to the continuing higher rates for males in the 0–11 and 12–17 age groups. The 12–17 age group had the highest population rates, with 9% of males and 5% of females in that age group dispensed a prescription for an ADHD medication in 2023–24 (Figure 4).

Total ADHD medication population and prescription rates for males under 18 years were higher than for females in the same age groups for each year, whereas population rates for females in the 18–24 and 25–44 age groups overtook those for males in these age groups for the first time in 2022–23 (Figure 4). Prescription rates for females in the 18–24, 25–44 and 45 years and over age groups exceeded the rates for males in corresponding age groups in 2023–24.

Remoteness and socioeconomic disadvantage

Remoteness area and quintile of socioeconomic disadvantage of patient’s usual residence are presented for 2022–23 and 2023–24 only, categorised by the latest indexes based on the 2021 Census.

Conclusion

The past 20 years has seen considerable increases in prescriptions dispensed for the treatment of ADHD. Noting that the effects of new or amended PBS listings contribute to some of the observed trends over time, particularly those related to age groups due to age-specific criteria, they do not fully explain increased dispensing or differences by demographic factors. A key demographic trend is the larger relative increase for females compared with males, which could be due to corrections of previous under-diagnosis of females (Young et al. 2020). This trend is most evident in the adult age groups over 18 where the population and prescriptions rates for females have exceeded that for males in the corresponding age groups in recent years.

The lower population and prescriptions rates for people residing in areas of greater socioeconomic disadvantage compared with those in areas of less disadvantage could be due to the out-of-pocket financial costs associated with ADHD diagnosis and ongoing treatment. Subsidised Medicare service availability and rebates are limited, and assessments are largely via the private sector (Senate Community Affairs References Committee 2023). Lower rates in Remote and very remote areas point towards geographic service barriers and reflect the lower rates of medical practitioners in remote areas (AIHW 2024).

There are multiple other complex social, environmental and clinical factors that could influence ADHD diagnosis and treatment rates. The available data on its own is insufficient to explore these factors, but this article provides important context and information to support further analysis and monitoring of ADHD-related prescription trends.

Where do I go for more information?

For more information on mental health services in Australia go to the Mental Health Online Report.