I've been waiting months for a psychiatrist appointment for ADHD. Does this help me now?

Not yet — the PBAC is considering the change at its September 2026 meeting, but no decision has been made and any change would not be immediate. In the meantime, it is worth talking to your GP about where you are in the process. Some GPs are already able to continue prescribing ADHD medications if a specialist has previously initiated them. If you have a diagnosis and a psychiatry referral in train, ask your GP whether anything can be done while you wait.

Why has ADHD in women been so underdiagnosed for so long?

ADHD in women and girls presents differently to the hyperactive-disruptive picture that shaped early research and clinical training. Inattentive-type ADHD — difficulties with sustained attention, organisation, and working memory, without obvious hyperactivity — is more common in women and was historically under-recognised. Many women receive their first diagnosis in their 30s or 40s, often prompted by a child's diagnosis or a period of high demand (new job, parenting stress, perimenopause) that strips away the compensatory strategies they had been relying on. The diagnostic backlog reflects decades of a narrower diagnostic frame.

PBAC may let GPs start non-stimulant ADHD drugs — a shift years overdue

What just happened

The Pharmaceutical Benefits Advisory Committee will consider at its September 2026 meeting whether to change the PBS listing for two non-stimulant ADHD medications — atomoxetine and guanfacine — to allow GPs to initiate prescribing, rather than requiring a specialist to start the medication first.

Currently, GPs can prescribe these drugs — but only if a non-GP specialist (psychiatrist, paediatrician, or neurologist) has already initiated treatment. The proposed change would allow GPs to initiate independently, without a prior specialist script.

This is not a decision yet. The PBAC will deliberate and provide a recommendation; a formal policy change, if recommended, would follow. But the fact that it is being considered at all reflects what anyone who has tried to access adult ADHD care in Australia in the last three years already knows: the system is not functioning at the demand now being placed on it.

Adult ADHD medication use in Australia has increased dramatically — from 0.35% of the population in 2016-17 to 2.36% in 2025, according to RACGP reporting. That is nearly a sevenfold increase in less than a decade. Specialist waitlists for ADHD assessment and initiation have lengthened accordingly: in many areas, waits of six to twelve months for a private psychiatry appointment are standard. Public mental health services rarely see adults with non-crisis presentations at all.

The bottleneck is not a mystery. The treatment pathway for adult ADHD requires specialist initiation — and specialist supply has not scaled anywhere near as fast as demand.

The both-and

Why the proposed change matters — especially for women

The case for broadening GP initiation authority is straightforward. GPs are already the clinicians most Australians see most often. They manage chronic conditions requiring long-term prescribing and monitoring across every organ system. For many adults with ADHD, the GP is already the clinician doing most of the follow-up work — reviewing whether the medication is effective, managing side effects, adjusting doses — because the prescribing psychiatrist has a wait list and the patient is seen perhaps once a year, if that.

The specific medications under review — atomoxetine (a noradrenaline reuptake inhibitor) and guanfacine (an alpha-2 agonist) — are non-stimulant agents. They are used in people who have not adequately responded to or cannot tolerate stimulant medications (methylphenidate, dexamphetamine). As Associate Professor John Kramer noted in RACGP coverage, expanding GP initiation authority “would enable practitioners to independently initiate treatment, reducing referral delays” for a patient population that has already waited long enough.

For women with ADHD specifically, this matters. Many women receive their diagnosis in midlife — often prompted by recognising ADHD in a child, or by a period of high demand that outstrips the compensatory strategies that got them through school and early career. Perimenopause is a particularly common trigger: the oestrogen fluctuation that characterises perimenopause affects dopamine and noradrenaline signalling, and can unmask ADHD symptoms that were previously managed, or amplify symptoms that were previously mild. Women presenting with newly problematic executive function, attention, and emotional regulation in their late 30s or 40s often have a long diagnostic odyssey ahead of them — and if it ends with a diagnosis, a specialist wait of six to twelve months for initiation comes after.

Allowing GPs to initiate would shorten that final delay substantially for many people.

What the change does not do

If the PBAC recommends broadening GP initiation authority, it will not eliminate the specialist bottleneck for diagnosis. Diagnosis of adult ADHD — the formal assessment that determines whether the diagnostic criteria are met — still requires thorough clinical evaluation. GPs are increasingly doing that work, but access to comprehensive assessment remains unequal.

The change also will not happen immediately. PBAC recommends; the government decides; PBS listing changes are then implemented with lead time. The practical effect for someone currently in a wait list is uncertain in timing.

There is also a reasonable conversation to be had about GP readiness and confidence in initiating non-stimulant ADHD medications in adults — particularly in people with complex presentations, comorbidities, or cardiovascular risk factors that require careful assessment before starting. A change in prescribing authority needs to be accompanied by appropriate support, education, and access to specialist advice when GPs need it.

None of that argues against the change. It argues for doing it properly.

My two cents

This is the kind of policy reform that, if it proceeds, will matter to a specific group of people in a very concrete way: adults with ADHD who are sitting in a months-long queue for a specialist appointment they need only to get a prescription, in a system where their GP is already managing most of their care.

It is also worth naming the pattern. Women with ADHD have been systematically underdiagnosed for decades — the diagnostic criteria and clinical training were built on a presentation pattern (hyperactive, disruptive, primarily boys) that describes a minority of women with the condition. The backlog that is now overwhelming specialist services is, in part, the consequence of that diagnostic lag finally being corrected. Women in their 30s, 40s, and 50s presenting with ADHD are not a new phenomenon. They are a long-overdue recognition of a group that was always there.

The PBAC process is slow but it is the right one. If you are currently waiting, talk to your GP about what is already available to you in your specific situation. If a specialist has previously initiated treatment, your GP may already be able to continue managing your prescription. If you are still in the assessment queue, ask what your GP can offer while you wait.

Verdict: maybe — the change is not yet made, but the direction is right and the evidence for broadening GP initiation authority is strong. Watch this space at the next PBAC update.

Sources cited

PBAC to consider ADHD drugs’ initiation requirements — newsGP, 31 August 2026. https://www1.racgp.org.au/newsgp/clinical/pbac-to-consider-adhd-drugs-initiation-requirement
Pharmaceutical Benefits Scheme — atomoxetine PBS listing. https://www.pbs.gov.au/medicine/item/13052F