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[post_content] => Morag Horton works alongside clinicians and nurses to ensure seamless IVF medicines supply and patient support.
How did you specialise in assisted reproductive therapy?
In 2013, I purchased a pharmacy involved in IVF and fertility treatment.
At that time, most medicines supply was made by IVF clinics directly to patients, and there was very little pharmacy involvement – other than for non-Medicare funded patients or medicines. I was dispensing medicines I’d never learnt about at university – nor in my career until then.
I struggled to find suitable training material, so I asked questions of IVF clinicians, nurses and pharmaceutical companies whenever the opportunity arose. I came to understand the medicines protocols used and became familiar with all the administration devices. In 2015, funding for the supply of IVF medicines changed to the Pharmaceutical Benefits Scheme (PBS) in the S100 category – meaning all supply now involved a pharmacist. The knowledge that I’d already gained meant I could support patients and their partners, as well as to the IVF clinic team, through and beyond this transition.
What does the role entail?
I help patients process huge amounts of information and complex medicines schedules, and access medicines that may not be available in their local community pharmacy. I also help to reduce or eliminate confusion or issues for patients e.g. insufficient prescribed quantities, missed items or last-minute medicines changes.
How do you help patients navigate their medicines regimen?
Being able to immediately understand the treatment protocol behind a bundle of prescriptions is important. Recognising the individual situation makes the patient feel more comfortable and understood. It also helps me tailor the information provided.
If the patient is anxious about injections and injection technique, I focus on the first item that needs to be used. This helps to ensure they’re not overwhelmed with three or more different products that may require different techniques or devices, and they feel more comfortable before adding in the next injection.
Clear and thorough labelling is also key, with storage information discussed and fridge items provided in a cooler bag with ice. I also provide written information to support verbal and online information, offering further support by telephone.
How do you manage medicines storage, cold-chain and supply?
We’ve increased fridge capacity and back up, built in business continuity planning, and use data loggers on all refrigerators. We also have a dedicated fridge for IVF medicines, as the packaging is bulky and prescriptions can involve large quantities. Ordering is done frequently, with close attention to supplier cut-off times, particularly later in the week.
We carefully balance stock levels, expiry risk and cash flow, while monitoring prescribing patterns and staying in close contact with fertility clinics about upcoming treatment cycles. We also ensure all supporting materials – such as brochures, cooler bags, ice bricks and other consumables – are available.
How do you collaborate with fertility clinics, prescribers and nurses?
In the beginning of my involvement in the IVF field, I asked questions of others with more experience. Now, they often ask me questions. I also encourage clinicians to understand PBS listings and to prescribe in accordance with the criteria.
The IVF clinicians can be hard to reach for prescription queries, so good relationships with IVF nurses and clinic staff are essential. As a member of the Fertility Society of Australia and Fertility Nurses of Australasia, I keep up with the latest information and news, and participate in continuing education events and conferences.
What advice do you have for ECPs keen on specialising in this area?
Build your knowledge and be confident in it, while remaining open-minded and supportive. Fertility treatment can place people under emotional, practical and financial pressure; pharmacists shouldn’t add to that burden.
A Day in the life of Morag Horton, community pharmacy owner, Adelaide, South Australia
| 8.00 am | Set up and check in IVF work fluctuates – some days it’s minimal, other days it’s constant. I check what’s booked/expected, confirm any urgent needs, and make sure there’s space for IVF stock. |
| 9.00 am | Ordering and supply planning Weekly ordering is done on Monday mornings and reviewed again on Wednesday because we can’t reliably order later in the week. This helps to protect continuity. |
| 10:30 am | Dispensary coordination My dispensary manager leads ordering of IVF medicines, support materials and consumables. She also prepares syringe/needle packs for medicines that require separate consumable supply, so patients receive everything together. |
| 12.00 pm | Clinic liaison Phone or email contact with IVF nurses occurs most days to clarify prescriptions, confirm timing and align supply with treatment cycles. |
| 2.00 pm | Prescription collection Our courier collects prescriptions from fertility clinics weekly, as not all clinics use e-scripts. These are processed promptly to avoid delays that could affect treatment timing. |
| 3.30 pm | Patient support IVF supply often includes practical support: ensuring patients have what they need for transport and storage, and that any supporting materials and consumables are ready alongside the medicines. |
| 6.00 pm | Engagement and training Some evenings may include a Fertility Nurses of Australia meeting, or delivering training sessions for fertility clinics for IVF clinicians and nurses. |
| 8.00 pm | Urgent supply Occasionally I’ll get an out-of-hours call from an IVF clinician to arrange emergency medicines supply, requiring rapid coordination to keep treatment on track. |
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[post_content] => A Canberra-based pharmacy has become the first to manage MDMA and psilocybin capsules for post-traumatic stress disorder (PTSD) and treatment-resistant depression in accordance with Therapeutic Goods Administration (TGA) regulations.
For Louise McLean FPS, co-owner of Capital Chemist Southlands, the milestone followed a lengthy approval process.
‘It was 12 months from when we received the phone call from the psychiatrist to say they were ready to submit their TGA Authorised Prescriber application until we dispensed the first prescription,’ she said.
[caption id="attachment_12027" align="aligncenter" width="500"]
Owner of Canberra's Capital Chemist Southlands Louise McLean MPS.[/caption]
‘But it was very rewarding to be able to be part of offering patients a new treatment option.
‘As a pharmacist, I have always wanted to make treatments more accessible for patients who need them.
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.’
Compliance is key
Psychiatrists must obtain TGA Authorised Prescriber status to work with a patient under the new treatment pathway. They then work in conjunction with a licensed pharmacist to arrange medicine supply.
‘I’ve worked closely with the psychiatrist we’re assisting for some time with medical cannabis and ketamine-assisted psychotherapy,’ Ms McLean said. ‘He is passionate about psychedelic medicine and novel therapies for PTSD and treatment-resistant depression.’
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.'
Louise McLean FPS
Ms McLean, a member of the Australian Medicinal Cannabis Association who has extensive experience managing cannabis prescriptions, said pharmacists considering involvement in psychedelic supply must be prepared for detailed compliance work.
‘You need an appetite to do the hard work involved in ensuring that all the legislative and regulatory requirements are followed,’ she said.
‘I began by contacting the TGA directly and spoke to our territory’s Health Protection Service (HPS) at length.
‘It’s imperative to include your team, who are integral to the success of the service. I am extremely fortunate to have exceptional staff.
For pharmacists in the ACT, handling MDMA and psilocybin requires compliance with the Medicines, Poisons and Therapeutic Goods Act 2008 and the Therapeutic Goods Regulation 2008. In addition, a Schedule 9 Licence is required to obtain and possess prohibited substances. These are also classified as prohibited substances under the Commonwealth Criminal Code.
‘In our case, we [also] needed to obtain a Medicines, Poisons and Therapeutic Good Licence from the Health Protection Service (HPS) in the ACT to obtain and possess MDMA and psilocybin capsules,’ Ms McLean said. ‘That took 5 months and HPS were supportive throughout the process.’
While some jurisdictions, such as Victoria, require a specific S9 licence, state or territory approvals are still required along with the TGA regulations.
Dispensing psychedelics safely
Before supplying psychedelic medicines, pharmacists need the psychiatrist’s TGA Authorised Prescriber approval paperwork on file to be able to order the medicine.
An additional requirement for prescribing and dispensing of MDMA or psilocybin within the ACT is Chief Officer Health approval specific for the individual patient and prescribed substance.
Patients are not permitted to handle the medicine outside supervised treatment sessions, and strict eligibility criteria must be met before therapy commences.
‘We dispense per treatment session,’ Ms McLean said.
‘Either the doctor collects it from the pharmacy, or we hand-deliver it to his private practice.
‘From our perspective, it’s about ensuring we’re following all licence requirements and having confidence that the doctor is practising legally and ethically.’
The cost of prescribed psychedelics ranges from $100–200 per capsule, with several potentially required per session depending on the dose. The medicines are not listed on the Pharmaceutical Benefits Scheme (PBS), although the Department of Veterans’ Affairs may fund treatment for eligible patients.
Capital Chemist Southlands works closely with a single supplier for both the MDMA and psilocybin capsules, with signature required upon courier delivery.
Stock management also requires care.
‘An MDMA bottle may contain 25 or 50 capsules and demand is, at this stage, very small. We’ve only dispensed it twice for a single patient, with their first treatment in January.’
Managing patient enquiries
Some patients with PTSD and treatment-resistant depression have enquired about alternative treatments, Ms McLean said.
‘It’s not appropriate for us to recommend [these specific treatments],’ she said. ‘If patients specifically ask about these novel therapies, our role is to have a general conversation and refer them to their doctor.’
For Ms McLean, the experience reflects the evolving scope of contemporary pharmacy practice – grounded in compliance, collaboration and patient-centred care.
Pharmacists may wish to contact the relevant state and territory health departments and/or refer to the MDMA and psilocybin hub on the TGA website. See the list of contacts for state/territory medicines & poisons regulation units.
For more information on MDMA and psilocybin complete the AP CPD 'The therapeutic potential of psychedelics'.
[post_title] => What’s involved in dispensing prescribed psychedelics?
[post_excerpt] => An ACT pharmacy became the first to manage psychedelics for PTSD and treatment-resistant depression in accordance with TGA regulations.
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[post_content] => Adrenaline (epinephrine) nasal spray (neffy) was recently approved by the Therapeutic Goods Administration (TGA) and is now available for use in Australia.
The launch of the product marks the first time in over 30 years that a new way of administering adrenaline has been approved in Australia.
So how useful will having a new dose form be? The answer isn’t clear – but the reaction has been positive.
Professor Connie Katelaris AM, a leading NSW allergist welcomes the additional option for care:
‘Anaphylaxis is a difficult condition to manage, with some patients reporting challenges. neffy has been available for some time overseas and now patients in Australia will have access.’
AP explores its place in therapy and whether it’s worth the price.
How does the nasal spray differ from EpiPen?
Similar to EpiPen, neffy delivers adrenaline, the active ingredient used to treat anaphylaxis, a spokesperson for CSL Seqirus, the manufacturer of the medicine, told AP.
‘[However it] doesn’t contain a needle and doesn't require an injection.’
[caption id="attachment_31382" align="aligncenter" width="500"]
Supplied by CSL Seqirus[/caption]
Using a similar delivery device as opioid reversal medicines, the nasal spray administers adrenaline via the nasal mucosa, enabling rapid absorption into the bloodstream.
Can it be placed in a resuscitation kit?
Yes, and no.
While neffy contains adrenaline and is indicated for the same purpose as injectable adrenaline normally kept as part of a resuscitation kit, there is a key difference.
‘Resuscitation kits generally stock items that are Schedule 3, and neffy is currently a Prescription only (Schedule 4) medication,’ the CSL spokesperson said.
Who is the nasal spray best suited to?
Adrenaline (epinephrine) nasal spray is indicated for emergency treatment of anaphylaxis in patients aged 4 years and older and weighing 15 kg or greater, offering an alternative administration route for those who may be needle-phobic – particularly young children.
The medicine comes in two strengths:
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[post_content] => Early monitoring, sensitive communication and guideline awareness are essential when medicines are used to manage youth mental health.
Almost two in five (around 40%) of Australians aged 16–24 years experience a mental disorder in any given year, with depression and anxiety frequently emerging during adolescence and early adulthood.
Despite clinical guidelines recommending psychological therapies such as cognitive behavioural therapy (CBT) as first-line treatment, antidepressants can be prescribed before CBT practice, said Ms Lily Pham MPS, a lecturer at the University of Sydney – who is presenting at the upcoming PSA webinar Antidepressants and adolescents – what every pharmacist should know.
‘Pharmacists often get prescriptions for antidepressants where a young person hasn't received CBT yet – particularly if they’re on a waiting list to receive CBT,’ she said. ‘Antidepressants are typically recommended to be used for 6–12 months before deprescribing should be considered. But we’re finding that doesn’t happen a lot of the time.’
There’s often a gap between guideline recommendations and what pharmacists actually encounter in day-to-day practice. So initiating conversations about treatment planning requires both confidence and clarity.
‘It’s about being able to engage in those conversations and also knowing what to do when you gain that information,’ Ms Pham said.
Bridging the gap when CBT is delayed
Conversations around mental health require careful attention to privacy and tone.
‘It’s important not to use judgmental language,’ Ms Pham said. ‘We might engage in conversation by saying, “I’m just going to ask you a couple of questions about this medication – would you feel comfortable with that?’
Explaining intent can reduce defensiveness and reframe the conversation as supportive rather than interrogative.
‘If you say, “The reason I'm asking is because I want to be able to give you information about the medication that's tailored to you” for example, it can often open up the conversation better,’ she said.
When sensitive topics, including mental health, are discussed, there should always be the option to move into a consultation room.
Pharmacists can also use simple, open-ended questions to explore whether broader treatment planning has been discussed.
‘It comes down to signposting,’ Ms Pham said. ‘You could ask, “is this the first time you’ve used this medication?” And then you might follow with, “When people start this medication, their GP can sometimes have conversations about other strategies, like CBT. Is that something you’ve discussed with your GP?”’
Given much antidepressant use in adolescents is off label, product information doesn’t clearly outline use in younger populations.
‘This is where guidelines specific to prescribing for younger people should be considered,’ she said.
Where clarification with the prescriber is required, young people should not be excluded from the process.
‘Young people often feel very disempowered within the healthcare system, so it’s important that health professionals support young people to have a voice in their healthcare,’ Ms Pham said. ‘If you are going to have those conversations, make sure you also include that young person. That might include saying, “would you mind if I speak to your GP to clarify XYZ details”, if those details haven't been established through your conversations with the young person.’
Checking duration against intention
Through dispensing histories and repeat supply intervals, pharmacists can prompt gentle check-ins around duration of and response to therapy.
‘If you’ve noticed in your dispensing system that a person has been on an antidepressant for over 12 months, flag a conversation with that young person about how they are feeling on the medication, how their mood is, and whether or not they have discussed with their GP about deprescribing or tapering the dose,’ Ms Pham said.
However, pharmacists should use their clinical judgement when approaching this conversation.
‘You would only really have that conversation if that person was faring well,’ she said. ‘If they say, “My mood’s still not great,” you’re not going to ask if they have decided to consider deprescribing. Instead, you might discuss openness to alternative drug regimens with them and their prescriber.’
Repeat supply also provides an opportunity to check whether appropriate review and deprescribing discussions have occurred.
‘You can flag whether this conversation has occurred using your dispensing system every 6 to 12 months,’ Ms Pham said.
Monitoring efficacy and tolerability
When dispensing antidepressants, pharmacists have the opportunity to monitor for both efficacy and adverse effects – particularly those that young people may feel reluctant to disclose.
‘One of the big ones is around sexual dysfunction,’ Ms Pham said. ‘So it's checking in with those short-and longer- term adverse effects, as well as looking at the efficacy of the medication and the need.’
Monitoring and review are shared responsibilities rather than isolated tasks.
‘There is an onus of responsibility on every member of the multidisciplinary healthcare team when you do come in contact, or you do interact with that young person, to check in,’ Ms Pham said.
Even under 60-day dispensing arrangements, pharmacists retain regular contact with young patients using antidepressants.
‘If the GP checks in with them at every appointment, and then the pharmacist once every 2 months – we can still provide touchpoints in that person’s care. And young people would appreciate being engaged in non-judgemental conversations about their care.’
Learn more about pharmacists’ role in the quality use of antidepressants for teens and young adults by attending the PSA webinar Antidepressants and adolescents – what every pharmacist should know, held on 17 February 2026 at 7.00–8.30 pm AEDT.
[post_title] => Supporting quality use of antidepressants in adolescents
[post_excerpt] => Early monitoring, sensitive communication and guideline awareness are essential when medicines are used to manage youth mental health.
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[post_content] => Complex, undiagnosed pelvic pain can often leave patients in awful limbo. Pharmacists can help them understand what drives – and can interrupt – pain.
For some people, severe and chronic pelvic pain persists despite extensive investigations and no confirmed diagnosis of endometriosis. In some cases, pain continues even after surgery to remove endometriosis lesions.
Other people may experience overlapping pain conditions such as bladder pain syndrome, irritable bowel syndrome or musculoskeletal dysfunction.
Without a diagnosis, these people often fall through the cracks – left managing debilitating pain with little clarity, validation or structured care.
‘Early intervention in pelvic pain is crucial to reduce the risk of maladaptation, central sensitisation and the significant social, work-related and mental health impacts of untreated pain,’ according to the Chairperson of Chronic Pain Australia, Nicolette Ellis MPS, a pharmacist.
Even without a confirmed diagnosis, commencing appropriate hormonal therapy and analgesics is recommended, she says. Medicines alone are rarely sufficient, and a pelvic pain physiotherapist is often the most important allied health referral to address muscle overactivity and contributors to persistent pain.
Ms Ellis says chronic pelvic pain is best managed through a team-based approach, where pharmacists, GPs, physiotherapists, psychologists and specialists each address different contributors to the pain experience. Clear communication and shared understanding between disciplines can improve outcomes significantly.
‘Around two in three people with chronic pain experience a secondary mental health condition,’ Ms Ellis says.
‘Catastrophising, rumination and helplessness are very common, especially when patients have been repeatedly bounced around the health system without answers.’
Free pain-specific supports like MindSpot, as well as peer networks such as PainLink helpline 1300 340 357 and Chronic Pain Australia’s support groups, can be invaluable, she says, alongside psychologists with an interest in pain.
Chronic vs acute pelvic pain
Acute pelvic pain typically presents suddenly, says Ms Ellis.
Often, it comes with red flags such as severe unilateral pain, fever, vomiting or rapid escalation, warranting urgent medical review. Chronic pelvic pain, in contrast, develops over months or years. It often follows patterns linked to menstrual cycles, bladder or bowel function, stress or muscle tension.
Many people with pelvic pain also dismiss their symptoms. Ms Ellis says they normalise heavy bleeding, bloating or discomfort, which can delay recognition that these patterns are not normal and require assessment. Chronic pelvic pain is defined as pain persisting for more than 3 months that does not need to occur daily. Pain that occurs on more than 10–15 days per month over a 3-month period is generally considered to meet the criteria.
‘A lack of diagnosis should never limit a clinician’s ability to treat, educate or support a patient in managing their pain.’ Ms Ellis stresses. See overleaf for two interesting case studies on undiagnosed pelvic pain that were not endometriosis.
Box 1 - Referral pathways
Pharmacists seeking help for patients with chronic or unexplained pelvic pain can
refer to:
|
Tahnee Simpson[/caption]
Nicolette Ellis MPS[/caption]
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[post_content] => Morag Horton works alongside clinicians and nurses to ensure seamless IVF medicines supply and patient support.
How did you specialise in assisted reproductive therapy?
In 2013, I purchased a pharmacy involved in IVF and fertility treatment.
At that time, most medicines supply was made by IVF clinics directly to patients, and there was very little pharmacy involvement – other than for non-Medicare funded patients or medicines. I was dispensing medicines I’d never learnt about at university – nor in my career until then.
I struggled to find suitable training material, so I asked questions of IVF clinicians, nurses and pharmaceutical companies whenever the opportunity arose. I came to understand the medicines protocols used and became familiar with all the administration devices. In 2015, funding for the supply of IVF medicines changed to the Pharmaceutical Benefits Scheme (PBS) in the S100 category – meaning all supply now involved a pharmacist. The knowledge that I’d already gained meant I could support patients and their partners, as well as to the IVF clinic team, through and beyond this transition.
What does the role entail?
I help patients process huge amounts of information and complex medicines schedules, and access medicines that may not be available in their local community pharmacy. I also help to reduce or eliminate confusion or issues for patients e.g. insufficient prescribed quantities, missed items or last-minute medicines changes.
How do you help patients navigate their medicines regimen?
Being able to immediately understand the treatment protocol behind a bundle of prescriptions is important. Recognising the individual situation makes the patient feel more comfortable and understood. It also helps me tailor the information provided.
If the patient is anxious about injections and injection technique, I focus on the first item that needs to be used. This helps to ensure they’re not overwhelmed with three or more different products that may require different techniques or devices, and they feel more comfortable before adding in the next injection.
Clear and thorough labelling is also key, with storage information discussed and fridge items provided in a cooler bag with ice. I also provide written information to support verbal and online information, offering further support by telephone.
How do you manage medicines storage, cold-chain and supply?
We’ve increased fridge capacity and back up, built in business continuity planning, and use data loggers on all refrigerators. We also have a dedicated fridge for IVF medicines, as the packaging is bulky and prescriptions can involve large quantities. Ordering is done frequently, with close attention to supplier cut-off times, particularly later in the week.
We carefully balance stock levels, expiry risk and cash flow, while monitoring prescribing patterns and staying in close contact with fertility clinics about upcoming treatment cycles. We also ensure all supporting materials – such as brochures, cooler bags, ice bricks and other consumables – are available.
How do you collaborate with fertility clinics, prescribers and nurses?
In the beginning of my involvement in the IVF field, I asked questions of others with more experience. Now, they often ask me questions. I also encourage clinicians to understand PBS listings and to prescribe in accordance with the criteria.
The IVF clinicians can be hard to reach for prescription queries, so good relationships with IVF nurses and clinic staff are essential. As a member of the Fertility Society of Australia and Fertility Nurses of Australasia, I keep up with the latest information and news, and participate in continuing education events and conferences.
What advice do you have for ECPs keen on specialising in this area?
Build your knowledge and be confident in it, while remaining open-minded and supportive. Fertility treatment can place people under emotional, practical and financial pressure; pharmacists shouldn’t add to that burden.
A Day in the life of Morag Horton, community pharmacy owner, Adelaide, South Australia
| 8.00 am | Set up and check in IVF work fluctuates – some days it’s minimal, other days it’s constant. I check what’s booked/expected, confirm any urgent needs, and make sure there’s space for IVF stock. |
| 9.00 am | Ordering and supply planning Weekly ordering is done on Monday mornings and reviewed again on Wednesday because we can’t reliably order later in the week. This helps to protect continuity. |
| 10:30 am | Dispensary coordination My dispensary manager leads ordering of IVF medicines, support materials and consumables. She also prepares syringe/needle packs for medicines that require separate consumable supply, so patients receive everything together. |
| 12.00 pm | Clinic liaison Phone or email contact with IVF nurses occurs most days to clarify prescriptions, confirm timing and align supply with treatment cycles. |
| 2.00 pm | Prescription collection Our courier collects prescriptions from fertility clinics weekly, as not all clinics use e-scripts. These are processed promptly to avoid delays that could affect treatment timing. |
| 3.30 pm | Patient support IVF supply often includes practical support: ensuring patients have what they need for transport and storage, and that any supporting materials and consumables are ready alongside the medicines. |
| 6.00 pm | Engagement and training Some evenings may include a Fertility Nurses of Australia meeting, or delivering training sessions for fertility clinics for IVF clinicians and nurses. |
| 8.00 pm | Urgent supply Occasionally I’ll get an out-of-hours call from an IVF clinician to arrange emergency medicines supply, requiring rapid coordination to keep treatment on track. |
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[post_content] => A Canberra-based pharmacy has become the first to manage MDMA and psilocybin capsules for post-traumatic stress disorder (PTSD) and treatment-resistant depression in accordance with Therapeutic Goods Administration (TGA) regulations.
For Louise McLean FPS, co-owner of Capital Chemist Southlands, the milestone followed a lengthy approval process.
‘It was 12 months from when we received the phone call from the psychiatrist to say they were ready to submit their TGA Authorised Prescriber application until we dispensed the first prescription,’ she said.
[caption id="attachment_12027" align="aligncenter" width="500"]
Owner of Canberra's Capital Chemist Southlands Louise McLean MPS.[/caption]
‘But it was very rewarding to be able to be part of offering patients a new treatment option.
‘As a pharmacist, I have always wanted to make treatments more accessible for patients who need them.
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.’
Compliance is key
Psychiatrists must obtain TGA Authorised Prescriber status to work with a patient under the new treatment pathway. They then work in conjunction with a licensed pharmacist to arrange medicine supply.
‘I’ve worked closely with the psychiatrist we’re assisting for some time with medical cannabis and ketamine-assisted psychotherapy,’ Ms McLean said. ‘He is passionate about psychedelic medicine and novel therapies for PTSD and treatment-resistant depression.’
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.'
Louise McLean FPS
Ms McLean, a member of the Australian Medicinal Cannabis Association who has extensive experience managing cannabis prescriptions, said pharmacists considering involvement in psychedelic supply must be prepared for detailed compliance work.
‘You need an appetite to do the hard work involved in ensuring that all the legislative and regulatory requirements are followed,’ she said.
‘I began by contacting the TGA directly and spoke to our territory’s Health Protection Service (HPS) at length.
‘It’s imperative to include your team, who are integral to the success of the service. I am extremely fortunate to have exceptional staff.
For pharmacists in the ACT, handling MDMA and psilocybin requires compliance with the Medicines, Poisons and Therapeutic Goods Act 2008 and the Therapeutic Goods Regulation 2008. In addition, a Schedule 9 Licence is required to obtain and possess prohibited substances. These are also classified as prohibited substances under the Commonwealth Criminal Code.
‘In our case, we [also] needed to obtain a Medicines, Poisons and Therapeutic Good Licence from the Health Protection Service (HPS) in the ACT to obtain and possess MDMA and psilocybin capsules,’ Ms McLean said. ‘That took 5 months and HPS were supportive throughout the process.’
While some jurisdictions, such as Victoria, require a specific S9 licence, state or territory approvals are still required along with the TGA regulations.
Dispensing psychedelics safely
Before supplying psychedelic medicines, pharmacists need the psychiatrist’s TGA Authorised Prescriber approval paperwork on file to be able to order the medicine.
An additional requirement for prescribing and dispensing of MDMA or psilocybin within the ACT is Chief Officer Health approval specific for the individual patient and prescribed substance.
Patients are not permitted to handle the medicine outside supervised treatment sessions, and strict eligibility criteria must be met before therapy commences.
‘We dispense per treatment session,’ Ms McLean said.
‘Either the doctor collects it from the pharmacy, or we hand-deliver it to his private practice.
‘From our perspective, it’s about ensuring we’re following all licence requirements and having confidence that the doctor is practising legally and ethically.’
The cost of prescribed psychedelics ranges from $100–200 per capsule, with several potentially required per session depending on the dose. The medicines are not listed on the Pharmaceutical Benefits Scheme (PBS), although the Department of Veterans’ Affairs may fund treatment for eligible patients.
Capital Chemist Southlands works closely with a single supplier for both the MDMA and psilocybin capsules, with signature required upon courier delivery.
Stock management also requires care.
‘An MDMA bottle may contain 25 or 50 capsules and demand is, at this stage, very small. We’ve only dispensed it twice for a single patient, with their first treatment in January.’
Managing patient enquiries
Some patients with PTSD and treatment-resistant depression have enquired about alternative treatments, Ms McLean said.
‘It’s not appropriate for us to recommend [these specific treatments],’ she said. ‘If patients specifically ask about these novel therapies, our role is to have a general conversation and refer them to their doctor.’
For Ms McLean, the experience reflects the evolving scope of contemporary pharmacy practice – grounded in compliance, collaboration and patient-centred care.
Pharmacists may wish to contact the relevant state and territory health departments and/or refer to the MDMA and psilocybin hub on the TGA website. See the list of contacts for state/territory medicines & poisons regulation units.
For more information on MDMA and psilocybin complete the AP CPD 'The therapeutic potential of psychedelics'.
[post_title] => What’s involved in dispensing prescribed psychedelics?
[post_excerpt] => An ACT pharmacy became the first to manage psychedelics for PTSD and treatment-resistant depression in accordance with TGA regulations.
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[post_content] => Adrenaline (epinephrine) nasal spray (neffy) was recently approved by the Therapeutic Goods Administration (TGA) and is now available for use in Australia.
The launch of the product marks the first time in over 30 years that a new way of administering adrenaline has been approved in Australia.
So how useful will having a new dose form be? The answer isn’t clear – but the reaction has been positive.
Professor Connie Katelaris AM, a leading NSW allergist welcomes the additional option for care:
‘Anaphylaxis is a difficult condition to manage, with some patients reporting challenges. neffy has been available for some time overseas and now patients in Australia will have access.’
AP explores its place in therapy and whether it’s worth the price.
How does the nasal spray differ from EpiPen?
Similar to EpiPen, neffy delivers adrenaline, the active ingredient used to treat anaphylaxis, a spokesperson for CSL Seqirus, the manufacturer of the medicine, told AP.
‘[However it] doesn’t contain a needle and doesn't require an injection.’
[caption id="attachment_31382" align="aligncenter" width="500"]
Supplied by CSL Seqirus[/caption]
Using a similar delivery device as opioid reversal medicines, the nasal spray administers adrenaline via the nasal mucosa, enabling rapid absorption into the bloodstream.
Can it be placed in a resuscitation kit?
Yes, and no.
While neffy contains adrenaline and is indicated for the same purpose as injectable adrenaline normally kept as part of a resuscitation kit, there is a key difference.
‘Resuscitation kits generally stock items that are Schedule 3, and neffy is currently a Prescription only (Schedule 4) medication,’ the CSL spokesperson said.
Who is the nasal spray best suited to?
Adrenaline (epinephrine) nasal spray is indicated for emergency treatment of anaphylaxis in patients aged 4 years and older and weighing 15 kg or greater, offering an alternative administration route for those who may be needle-phobic – particularly young children.
The medicine comes in two strengths:
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[post_content] => Early monitoring, sensitive communication and guideline awareness are essential when medicines are used to manage youth mental health.
Almost two in five (around 40%) of Australians aged 16–24 years experience a mental disorder in any given year, with depression and anxiety frequently emerging during adolescence and early adulthood.
Despite clinical guidelines recommending psychological therapies such as cognitive behavioural therapy (CBT) as first-line treatment, antidepressants can be prescribed before CBT practice, said Ms Lily Pham MPS, a lecturer at the University of Sydney – who is presenting at the upcoming PSA webinar Antidepressants and adolescents – what every pharmacist should know.
‘Pharmacists often get prescriptions for antidepressants where a young person hasn't received CBT yet – particularly if they’re on a waiting list to receive CBT,’ she said. ‘Antidepressants are typically recommended to be used for 6–12 months before deprescribing should be considered. But we’re finding that doesn’t happen a lot of the time.’
There’s often a gap between guideline recommendations and what pharmacists actually encounter in day-to-day practice. So initiating conversations about treatment planning requires both confidence and clarity.
‘It’s about being able to engage in those conversations and also knowing what to do when you gain that information,’ Ms Pham said.
Bridging the gap when CBT is delayed
Conversations around mental health require careful attention to privacy and tone.
‘It’s important not to use judgmental language,’ Ms Pham said. ‘We might engage in conversation by saying, “I’m just going to ask you a couple of questions about this medication – would you feel comfortable with that?’
Explaining intent can reduce defensiveness and reframe the conversation as supportive rather than interrogative.
‘If you say, “The reason I'm asking is because I want to be able to give you information about the medication that's tailored to you” for example, it can often open up the conversation better,’ she said.
When sensitive topics, including mental health, are discussed, there should always be the option to move into a consultation room.
Pharmacists can also use simple, open-ended questions to explore whether broader treatment planning has been discussed.
‘It comes down to signposting,’ Ms Pham said. ‘You could ask, “is this the first time you’ve used this medication?” And then you might follow with, “When people start this medication, their GP can sometimes have conversations about other strategies, like CBT. Is that something you’ve discussed with your GP?”’
Given much antidepressant use in adolescents is off label, product information doesn’t clearly outline use in younger populations.
‘This is where guidelines specific to prescribing for younger people should be considered,’ she said.
Where clarification with the prescriber is required, young people should not be excluded from the process.
‘Young people often feel very disempowered within the healthcare system, so it’s important that health professionals support young people to have a voice in their healthcare,’ Ms Pham said. ‘If you are going to have those conversations, make sure you also include that young person. That might include saying, “would you mind if I speak to your GP to clarify XYZ details”, if those details haven't been established through your conversations with the young person.’
Checking duration against intention
Through dispensing histories and repeat supply intervals, pharmacists can prompt gentle check-ins around duration of and response to therapy.
‘If you’ve noticed in your dispensing system that a person has been on an antidepressant for over 12 months, flag a conversation with that young person about how they are feeling on the medication, how their mood is, and whether or not they have discussed with their GP about deprescribing or tapering the dose,’ Ms Pham said.
However, pharmacists should use their clinical judgement when approaching this conversation.
‘You would only really have that conversation if that person was faring well,’ she said. ‘If they say, “My mood’s still not great,” you’re not going to ask if they have decided to consider deprescribing. Instead, you might discuss openness to alternative drug regimens with them and their prescriber.’
Repeat supply also provides an opportunity to check whether appropriate review and deprescribing discussions have occurred.
‘You can flag whether this conversation has occurred using your dispensing system every 6 to 12 months,’ Ms Pham said.
Monitoring efficacy and tolerability
When dispensing antidepressants, pharmacists have the opportunity to monitor for both efficacy and adverse effects – particularly those that young people may feel reluctant to disclose.
‘One of the big ones is around sexual dysfunction,’ Ms Pham said. ‘So it's checking in with those short-and longer- term adverse effects, as well as looking at the efficacy of the medication and the need.’
Monitoring and review are shared responsibilities rather than isolated tasks.
‘There is an onus of responsibility on every member of the multidisciplinary healthcare team when you do come in contact, or you do interact with that young person, to check in,’ Ms Pham said.
Even under 60-day dispensing arrangements, pharmacists retain regular contact with young patients using antidepressants.
‘If the GP checks in with them at every appointment, and then the pharmacist once every 2 months – we can still provide touchpoints in that person’s care. And young people would appreciate being engaged in non-judgemental conversations about their care.’
Learn more about pharmacists’ role in the quality use of antidepressants for teens and young adults by attending the PSA webinar Antidepressants and adolescents – what every pharmacist should know, held on 17 February 2026 at 7.00–8.30 pm AEDT.
[post_title] => Supporting quality use of antidepressants in adolescents
[post_excerpt] => Early monitoring, sensitive communication and guideline awareness are essential when medicines are used to manage youth mental health.
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[post_content] => Complex, undiagnosed pelvic pain can often leave patients in awful limbo. Pharmacists can help them understand what drives – and can interrupt – pain.
For some people, severe and chronic pelvic pain persists despite extensive investigations and no confirmed diagnosis of endometriosis. In some cases, pain continues even after surgery to remove endometriosis lesions.
Other people may experience overlapping pain conditions such as bladder pain syndrome, irritable bowel syndrome or musculoskeletal dysfunction.
Without a diagnosis, these people often fall through the cracks – left managing debilitating pain with little clarity, validation or structured care.
‘Early intervention in pelvic pain is crucial to reduce the risk of maladaptation, central sensitisation and the significant social, work-related and mental health impacts of untreated pain,’ according to the Chairperson of Chronic Pain Australia, Nicolette Ellis MPS, a pharmacist.
Even without a confirmed diagnosis, commencing appropriate hormonal therapy and analgesics is recommended, she says. Medicines alone are rarely sufficient, and a pelvic pain physiotherapist is often the most important allied health referral to address muscle overactivity and contributors to persistent pain.
Ms Ellis says chronic pelvic pain is best managed through a team-based approach, where pharmacists, GPs, physiotherapists, psychologists and specialists each address different contributors to the pain experience. Clear communication and shared understanding between disciplines can improve outcomes significantly.
‘Around two in three people with chronic pain experience a secondary mental health condition,’ Ms Ellis says.
‘Catastrophising, rumination and helplessness are very common, especially when patients have been repeatedly bounced around the health system without answers.’
Free pain-specific supports like MindSpot, as well as peer networks such as PainLink helpline 1300 340 357 and Chronic Pain Australia’s support groups, can be invaluable, she says, alongside psychologists with an interest in pain.
Chronic vs acute pelvic pain
Acute pelvic pain typically presents suddenly, says Ms Ellis.
Often, it comes with red flags such as severe unilateral pain, fever, vomiting or rapid escalation, warranting urgent medical review. Chronic pelvic pain, in contrast, develops over months or years. It often follows patterns linked to menstrual cycles, bladder or bowel function, stress or muscle tension.
Many people with pelvic pain also dismiss their symptoms. Ms Ellis says they normalise heavy bleeding, bloating or discomfort, which can delay recognition that these patterns are not normal and require assessment. Chronic pelvic pain is defined as pain persisting for more than 3 months that does not need to occur daily. Pain that occurs on more than 10–15 days per month over a 3-month period is generally considered to meet the criteria.
‘A lack of diagnosis should never limit a clinician’s ability to treat, educate or support a patient in managing their pain.’ Ms Ellis stresses. See overleaf for two interesting case studies on undiagnosed pelvic pain that were not endometriosis.
Box 1 - Referral pathways
Pharmacists seeking help for patients with chronic or unexplained pelvic pain can
refer to:
|
Tahnee Simpson[/caption]
Nicolette Ellis MPS[/caption]
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[post_content] => Morag Horton works alongside clinicians and nurses to ensure seamless IVF medicines supply and patient support.
How did you specialise in assisted reproductive therapy?
In 2013, I purchased a pharmacy involved in IVF and fertility treatment.
At that time, most medicines supply was made by IVF clinics directly to patients, and there was very little pharmacy involvement – other than for non-Medicare funded patients or medicines. I was dispensing medicines I’d never learnt about at university – nor in my career until then.
I struggled to find suitable training material, so I asked questions of IVF clinicians, nurses and pharmaceutical companies whenever the opportunity arose. I came to understand the medicines protocols used and became familiar with all the administration devices. In 2015, funding for the supply of IVF medicines changed to the Pharmaceutical Benefits Scheme (PBS) in the S100 category – meaning all supply now involved a pharmacist. The knowledge that I’d already gained meant I could support patients and their partners, as well as to the IVF clinic team, through and beyond this transition.
What does the role entail?
I help patients process huge amounts of information and complex medicines schedules, and access medicines that may not be available in their local community pharmacy. I also help to reduce or eliminate confusion or issues for patients e.g. insufficient prescribed quantities, missed items or last-minute medicines changes.
How do you help patients navigate their medicines regimen?
Being able to immediately understand the treatment protocol behind a bundle of prescriptions is important. Recognising the individual situation makes the patient feel more comfortable and understood. It also helps me tailor the information provided.
If the patient is anxious about injections and injection technique, I focus on the first item that needs to be used. This helps to ensure they’re not overwhelmed with three or more different products that may require different techniques or devices, and they feel more comfortable before adding in the next injection.
Clear and thorough labelling is also key, with storage information discussed and fridge items provided in a cooler bag with ice. I also provide written information to support verbal and online information, offering further support by telephone.
How do you manage medicines storage, cold-chain and supply?
We’ve increased fridge capacity and back up, built in business continuity planning, and use data loggers on all refrigerators. We also have a dedicated fridge for IVF medicines, as the packaging is bulky and prescriptions can involve large quantities. Ordering is done frequently, with close attention to supplier cut-off times, particularly later in the week.
We carefully balance stock levels, expiry risk and cash flow, while monitoring prescribing patterns and staying in close contact with fertility clinics about upcoming treatment cycles. We also ensure all supporting materials – such as brochures, cooler bags, ice bricks and other consumables – are available.
How do you collaborate with fertility clinics, prescribers and nurses?
In the beginning of my involvement in the IVF field, I asked questions of others with more experience. Now, they often ask me questions. I also encourage clinicians to understand PBS listings and to prescribe in accordance with the criteria.
The IVF clinicians can be hard to reach for prescription queries, so good relationships with IVF nurses and clinic staff are essential. As a member of the Fertility Society of Australia and Fertility Nurses of Australasia, I keep up with the latest information and news, and participate in continuing education events and conferences.
What advice do you have for ECPs keen on specialising in this area?
Build your knowledge and be confident in it, while remaining open-minded and supportive. Fertility treatment can place people under emotional, practical and financial pressure; pharmacists shouldn’t add to that burden.
A Day in the life of Morag Horton, community pharmacy owner, Adelaide, South Australia
| 8.00 am | Set up and check in IVF work fluctuates – some days it’s minimal, other days it’s constant. I check what’s booked/expected, confirm any urgent needs, and make sure there’s space for IVF stock. |
| 9.00 am | Ordering and supply planning Weekly ordering is done on Monday mornings and reviewed again on Wednesday because we can’t reliably order later in the week. This helps to protect continuity. |
| 10:30 am | Dispensary coordination My dispensary manager leads ordering of IVF medicines, support materials and consumables. She also prepares syringe/needle packs for medicines that require separate consumable supply, so patients receive everything together. |
| 12.00 pm | Clinic liaison Phone or email contact with IVF nurses occurs most days to clarify prescriptions, confirm timing and align supply with treatment cycles. |
| 2.00 pm | Prescription collection Our courier collects prescriptions from fertility clinics weekly, as not all clinics use e-scripts. These are processed promptly to avoid delays that could affect treatment timing. |
| 3.30 pm | Patient support IVF supply often includes practical support: ensuring patients have what they need for transport and storage, and that any supporting materials and consumables are ready alongside the medicines. |
| 6.00 pm | Engagement and training Some evenings may include a Fertility Nurses of Australia meeting, or delivering training sessions for fertility clinics for IVF clinicians and nurses. |
| 8.00 pm | Urgent supply Occasionally I’ll get an out-of-hours call from an IVF clinician to arrange emergency medicines supply, requiring rapid coordination to keep treatment on track. |
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[post_content] => A Canberra-based pharmacy has become the first to manage MDMA and psilocybin capsules for post-traumatic stress disorder (PTSD) and treatment-resistant depression in accordance with Therapeutic Goods Administration (TGA) regulations.
For Louise McLean FPS, co-owner of Capital Chemist Southlands, the milestone followed a lengthy approval process.
‘It was 12 months from when we received the phone call from the psychiatrist to say they were ready to submit their TGA Authorised Prescriber application until we dispensed the first prescription,’ she said.
[caption id="attachment_12027" align="aligncenter" width="500"]
Owner of Canberra's Capital Chemist Southlands Louise McLean MPS.[/caption]
‘But it was very rewarding to be able to be part of offering patients a new treatment option.
‘As a pharmacist, I have always wanted to make treatments more accessible for patients who need them.
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.’
Compliance is key
Psychiatrists must obtain TGA Authorised Prescriber status to work with a patient under the new treatment pathway. They then work in conjunction with a licensed pharmacist to arrange medicine supply.
‘I’ve worked closely with the psychiatrist we’re assisting for some time with medical cannabis and ketamine-assisted psychotherapy,’ Ms McLean said. ‘He is passionate about psychedelic medicine and novel therapies for PTSD and treatment-resistant depression.’
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.'
Louise McLean FPS
Ms McLean, a member of the Australian Medicinal Cannabis Association who has extensive experience managing cannabis prescriptions, said pharmacists considering involvement in psychedelic supply must be prepared for detailed compliance work.
‘You need an appetite to do the hard work involved in ensuring that all the legislative and regulatory requirements are followed,’ she said.
‘I began by contacting the TGA directly and spoke to our territory’s Health Protection Service (HPS) at length.
‘It’s imperative to include your team, who are integral to the success of the service. I am extremely fortunate to have exceptional staff.
For pharmacists in the ACT, handling MDMA and psilocybin requires compliance with the Medicines, Poisons and Therapeutic Goods Act 2008 and the Therapeutic Goods Regulation 2008. In addition, a Schedule 9 Licence is required to obtain and possess prohibited substances. These are also classified as prohibited substances under the Commonwealth Criminal Code.
‘In our case, we [also] needed to obtain a Medicines, Poisons and Therapeutic Good Licence from the Health Protection Service (HPS) in the ACT to obtain and possess MDMA and psilocybin capsules,’ Ms McLean said. ‘That took 5 months and HPS were supportive throughout the process.’
While some jurisdictions, such as Victoria, require a specific S9 licence, state or territory approvals are still required along with the TGA regulations.
Dispensing psychedelics safely
Before supplying psychedelic medicines, pharmacists need the psychiatrist’s TGA Authorised Prescriber approval paperwork on file to be able to order the medicine.
An additional requirement for prescribing and dispensing of MDMA or psilocybin within the ACT is Chief Officer Health approval specific for the individual patient and prescribed substance.
Patients are not permitted to handle the medicine outside supervised treatment sessions, and strict eligibility criteria must be met before therapy commences.
‘We dispense per treatment session,’ Ms McLean said.
‘Either the doctor collects it from the pharmacy, or we hand-deliver it to his private practice.
‘From our perspective, it’s about ensuring we’re following all licence requirements and having confidence that the doctor is practising legally and ethically.’
The cost of prescribed psychedelics ranges from $100–200 per capsule, with several potentially required per session depending on the dose. The medicines are not listed on the Pharmaceutical Benefits Scheme (PBS), although the Department of Veterans’ Affairs may fund treatment for eligible patients.
Capital Chemist Southlands works closely with a single supplier for both the MDMA and psilocybin capsules, with signature required upon courier delivery.
Stock management also requires care.
‘An MDMA bottle may contain 25 or 50 capsules and demand is, at this stage, very small. We’ve only dispensed it twice for a single patient, with their first treatment in January.’
Managing patient enquiries
Some patients with PTSD and treatment-resistant depression have enquired about alternative treatments, Ms McLean said.
‘It’s not appropriate for us to recommend [these specific treatments],’ she said. ‘If patients specifically ask about these novel therapies, our role is to have a general conversation and refer them to their doctor.’
For Ms McLean, the experience reflects the evolving scope of contemporary pharmacy practice – grounded in compliance, collaboration and patient-centred care.
Pharmacists may wish to contact the relevant state and territory health departments and/or refer to the MDMA and psilocybin hub on the TGA website. See the list of contacts for state/territory medicines & poisons regulation units.
For more information on MDMA and psilocybin complete the AP CPD 'The therapeutic potential of psychedelics'.
[post_title] => What’s involved in dispensing prescribed psychedelics?
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[post_content] => Adrenaline (epinephrine) nasal spray (neffy) was recently approved by the Therapeutic Goods Administration (TGA) and is now available for use in Australia.
The launch of the product marks the first time in over 30 years that a new way of administering adrenaline has been approved in Australia.
So how useful will having a new dose form be? The answer isn’t clear – but the reaction has been positive.
Professor Connie Katelaris AM, a leading NSW allergist welcomes the additional option for care:
‘Anaphylaxis is a difficult condition to manage, with some patients reporting challenges. neffy has been available for some time overseas and now patients in Australia will have access.’
AP explores its place in therapy and whether it’s worth the price.
How does the nasal spray differ from EpiPen?
Similar to EpiPen, neffy delivers adrenaline, the active ingredient used to treat anaphylaxis, a spokesperson for CSL Seqirus, the manufacturer of the medicine, told AP.
‘[However it] doesn’t contain a needle and doesn't require an injection.’
[caption id="attachment_31382" align="aligncenter" width="500"]
Supplied by CSL Seqirus[/caption]
Using a similar delivery device as opioid reversal medicines, the nasal spray administers adrenaline via the nasal mucosa, enabling rapid absorption into the bloodstream.
Can it be placed in a resuscitation kit?
Yes, and no.
While neffy contains adrenaline and is indicated for the same purpose as injectable adrenaline normally kept as part of a resuscitation kit, there is a key difference.
‘Resuscitation kits generally stock items that are Schedule 3, and neffy is currently a Prescription only (Schedule 4) medication,’ the CSL spokesperson said.
Who is the nasal spray best suited to?
Adrenaline (epinephrine) nasal spray is indicated for emergency treatment of anaphylaxis in patients aged 4 years and older and weighing 15 kg or greater, offering an alternative administration route for those who may be needle-phobic – particularly young children.
The medicine comes in two strengths:
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[post_content] => Early monitoring, sensitive communication and guideline awareness are essential when medicines are used to manage youth mental health.
Almost two in five (around 40%) of Australians aged 16–24 years experience a mental disorder in any given year, with depression and anxiety frequently emerging during adolescence and early adulthood.
Despite clinical guidelines recommending psychological therapies such as cognitive behavioural therapy (CBT) as first-line treatment, antidepressants can be prescribed before CBT practice, said Ms Lily Pham MPS, a lecturer at the University of Sydney – who is presenting at the upcoming PSA webinar Antidepressants and adolescents – what every pharmacist should know.
‘Pharmacists often get prescriptions for antidepressants where a young person hasn't received CBT yet – particularly if they’re on a waiting list to receive CBT,’ she said. ‘Antidepressants are typically recommended to be used for 6–12 months before deprescribing should be considered. But we’re finding that doesn’t happen a lot of the time.’
There’s often a gap between guideline recommendations and what pharmacists actually encounter in day-to-day practice. So initiating conversations about treatment planning requires both confidence and clarity.
‘It’s about being able to engage in those conversations and also knowing what to do when you gain that information,’ Ms Pham said.
Bridging the gap when CBT is delayed
Conversations around mental health require careful attention to privacy and tone.
‘It’s important not to use judgmental language,’ Ms Pham said. ‘We might engage in conversation by saying, “I’m just going to ask you a couple of questions about this medication – would you feel comfortable with that?’
Explaining intent can reduce defensiveness and reframe the conversation as supportive rather than interrogative.
‘If you say, “The reason I'm asking is because I want to be able to give you information about the medication that's tailored to you” for example, it can often open up the conversation better,’ she said.
When sensitive topics, including mental health, are discussed, there should always be the option to move into a consultation room.
Pharmacists can also use simple, open-ended questions to explore whether broader treatment planning has been discussed.
‘It comes down to signposting,’ Ms Pham said. ‘You could ask, “is this the first time you’ve used this medication?” And then you might follow with, “When people start this medication, their GP can sometimes have conversations about other strategies, like CBT. Is that something you’ve discussed with your GP?”’
Given much antidepressant use in adolescents is off label, product information doesn’t clearly outline use in younger populations.
‘This is where guidelines specific to prescribing for younger people should be considered,’ she said.
Where clarification with the prescriber is required, young people should not be excluded from the process.
‘Young people often feel very disempowered within the healthcare system, so it’s important that health professionals support young people to have a voice in their healthcare,’ Ms Pham said. ‘If you are going to have those conversations, make sure you also include that young person. That might include saying, “would you mind if I speak to your GP to clarify XYZ details”, if those details haven't been established through your conversations with the young person.’
Checking duration against intention
Through dispensing histories and repeat supply intervals, pharmacists can prompt gentle check-ins around duration of and response to therapy.
‘If you’ve noticed in your dispensing system that a person has been on an antidepressant for over 12 months, flag a conversation with that young person about how they are feeling on the medication, how their mood is, and whether or not they have discussed with their GP about deprescribing or tapering the dose,’ Ms Pham said.
However, pharmacists should use their clinical judgement when approaching this conversation.
‘You would only really have that conversation if that person was faring well,’ she said. ‘If they say, “My mood’s still not great,” you’re not going to ask if they have decided to consider deprescribing. Instead, you might discuss openness to alternative drug regimens with them and their prescriber.’
Repeat supply also provides an opportunity to check whether appropriate review and deprescribing discussions have occurred.
‘You can flag whether this conversation has occurred using your dispensing system every 6 to 12 months,’ Ms Pham said.
Monitoring efficacy and tolerability
When dispensing antidepressants, pharmacists have the opportunity to monitor for both efficacy and adverse effects – particularly those that young people may feel reluctant to disclose.
‘One of the big ones is around sexual dysfunction,’ Ms Pham said. ‘So it's checking in with those short-and longer- term adverse effects, as well as looking at the efficacy of the medication and the need.’
Monitoring and review are shared responsibilities rather than isolated tasks.
‘There is an onus of responsibility on every member of the multidisciplinary healthcare team when you do come in contact, or you do interact with that young person, to check in,’ Ms Pham said.
Even under 60-day dispensing arrangements, pharmacists retain regular contact with young patients using antidepressants.
‘If the GP checks in with them at every appointment, and then the pharmacist once every 2 months – we can still provide touchpoints in that person’s care. And young people would appreciate being engaged in non-judgemental conversations about their care.’
Learn more about pharmacists’ role in the quality use of antidepressants for teens and young adults by attending the PSA webinar Antidepressants and adolescents – what every pharmacist should know, held on 17 February 2026 at 7.00–8.30 pm AEDT.
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[post_content] => Complex, undiagnosed pelvic pain can often leave patients in awful limbo. Pharmacists can help them understand what drives – and can interrupt – pain.
For some people, severe and chronic pelvic pain persists despite extensive investigations and no confirmed diagnosis of endometriosis. In some cases, pain continues even after surgery to remove endometriosis lesions.
Other people may experience overlapping pain conditions such as bladder pain syndrome, irritable bowel syndrome or musculoskeletal dysfunction.
Without a diagnosis, these people often fall through the cracks – left managing debilitating pain with little clarity, validation or structured care.
‘Early intervention in pelvic pain is crucial to reduce the risk of maladaptation, central sensitisation and the significant social, work-related and mental health impacts of untreated pain,’ according to the Chairperson of Chronic Pain Australia, Nicolette Ellis MPS, a pharmacist.
Even without a confirmed diagnosis, commencing appropriate hormonal therapy and analgesics is recommended, she says. Medicines alone are rarely sufficient, and a pelvic pain physiotherapist is often the most important allied health referral to address muscle overactivity and contributors to persistent pain.
Ms Ellis says chronic pelvic pain is best managed through a team-based approach, where pharmacists, GPs, physiotherapists, psychologists and specialists each address different contributors to the pain experience. Clear communication and shared understanding between disciplines can improve outcomes significantly.
‘Around two in three people with chronic pain experience a secondary mental health condition,’ Ms Ellis says.
‘Catastrophising, rumination and helplessness are very common, especially when patients have been repeatedly bounced around the health system without answers.’
Free pain-specific supports like MindSpot, as well as peer networks such as PainLink helpline 1300 340 357 and Chronic Pain Australia’s support groups, can be invaluable, she says, alongside psychologists with an interest in pain.
Chronic vs acute pelvic pain
Acute pelvic pain typically presents suddenly, says Ms Ellis.
Often, it comes with red flags such as severe unilateral pain, fever, vomiting or rapid escalation, warranting urgent medical review. Chronic pelvic pain, in contrast, develops over months or years. It often follows patterns linked to menstrual cycles, bladder or bowel function, stress or muscle tension.
Many people with pelvic pain also dismiss their symptoms. Ms Ellis says they normalise heavy bleeding, bloating or discomfort, which can delay recognition that these patterns are not normal and require assessment. Chronic pelvic pain is defined as pain persisting for more than 3 months that does not need to occur daily. Pain that occurs on more than 10–15 days per month over a 3-month period is generally considered to meet the criteria.
‘A lack of diagnosis should never limit a clinician’s ability to treat, educate or support a patient in managing their pain.’ Ms Ellis stresses. See overleaf for two interesting case studies on undiagnosed pelvic pain that were not endometriosis.
Box 1 - Referral pathways
Pharmacists seeking help for patients with chronic or unexplained pelvic pain can
refer to:
|
Tahnee Simpson[/caption]
Nicolette Ellis MPS[/caption]
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[post_content] => Morag Horton works alongside clinicians and nurses to ensure seamless IVF medicines supply and patient support.
How did you specialise in assisted reproductive therapy?
In 2013, I purchased a pharmacy involved in IVF and fertility treatment.
At that time, most medicines supply was made by IVF clinics directly to patients, and there was very little pharmacy involvement – other than for non-Medicare funded patients or medicines. I was dispensing medicines I’d never learnt about at university – nor in my career until then.
I struggled to find suitable training material, so I asked questions of IVF clinicians, nurses and pharmaceutical companies whenever the opportunity arose. I came to understand the medicines protocols used and became familiar with all the administration devices. In 2015, funding for the supply of IVF medicines changed to the Pharmaceutical Benefits Scheme (PBS) in the S100 category – meaning all supply now involved a pharmacist. The knowledge that I’d already gained meant I could support patients and their partners, as well as to the IVF clinic team, through and beyond this transition.
What does the role entail?
I help patients process huge amounts of information and complex medicines schedules, and access medicines that may not be available in their local community pharmacy. I also help to reduce or eliminate confusion or issues for patients e.g. insufficient prescribed quantities, missed items or last-minute medicines changes.
How do you help patients navigate their medicines regimen?
Being able to immediately understand the treatment protocol behind a bundle of prescriptions is important. Recognising the individual situation makes the patient feel more comfortable and understood. It also helps me tailor the information provided.
If the patient is anxious about injections and injection technique, I focus on the first item that needs to be used. This helps to ensure they’re not overwhelmed with three or more different products that may require different techniques or devices, and they feel more comfortable before adding in the next injection.
Clear and thorough labelling is also key, with storage information discussed and fridge items provided in a cooler bag with ice. I also provide written information to support verbal and online information, offering further support by telephone.
How do you manage medicines storage, cold-chain and supply?
We’ve increased fridge capacity and back up, built in business continuity planning, and use data loggers on all refrigerators. We also have a dedicated fridge for IVF medicines, as the packaging is bulky and prescriptions can involve large quantities. Ordering is done frequently, with close attention to supplier cut-off times, particularly later in the week.
We carefully balance stock levels, expiry risk and cash flow, while monitoring prescribing patterns and staying in close contact with fertility clinics about upcoming treatment cycles. We also ensure all supporting materials – such as brochures, cooler bags, ice bricks and other consumables – are available.
How do you collaborate with fertility clinics, prescribers and nurses?
In the beginning of my involvement in the IVF field, I asked questions of others with more experience. Now, they often ask me questions. I also encourage clinicians to understand PBS listings and to prescribe in accordance with the criteria.
The IVF clinicians can be hard to reach for prescription queries, so good relationships with IVF nurses and clinic staff are essential. As a member of the Fertility Society of Australia and Fertility Nurses of Australasia, I keep up with the latest information and news, and participate in continuing education events and conferences.
What advice do you have for ECPs keen on specialising in this area?
Build your knowledge and be confident in it, while remaining open-minded and supportive. Fertility treatment can place people under emotional, practical and financial pressure; pharmacists shouldn’t add to that burden.
A Day in the life of Morag Horton, community pharmacy owner, Adelaide, South Australia
| 8.00 am | Set up and check in IVF work fluctuates – some days it’s minimal, other days it’s constant. I check what’s booked/expected, confirm any urgent needs, and make sure there’s space for IVF stock. |
| 9.00 am | Ordering and supply planning Weekly ordering is done on Monday mornings and reviewed again on Wednesday because we can’t reliably order later in the week. This helps to protect continuity. |
| 10:30 am | Dispensary coordination My dispensary manager leads ordering of IVF medicines, support materials and consumables. She also prepares syringe/needle packs for medicines that require separate consumable supply, so patients receive everything together. |
| 12.00 pm | Clinic liaison Phone or email contact with IVF nurses occurs most days to clarify prescriptions, confirm timing and align supply with treatment cycles. |
| 2.00 pm | Prescription collection Our courier collects prescriptions from fertility clinics weekly, as not all clinics use e-scripts. These are processed promptly to avoid delays that could affect treatment timing. |
| 3.30 pm | Patient support IVF supply often includes practical support: ensuring patients have what they need for transport and storage, and that any supporting materials and consumables are ready alongside the medicines. |
| 6.00 pm | Engagement and training Some evenings may include a Fertility Nurses of Australia meeting, or delivering training sessions for fertility clinics for IVF clinicians and nurses. |
| 8.00 pm | Urgent supply Occasionally I’ll get an out-of-hours call from an IVF clinician to arrange emergency medicines supply, requiring rapid coordination to keep treatment on track. |
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[post_content] => A Canberra-based pharmacy has become the first to manage MDMA and psilocybin capsules for post-traumatic stress disorder (PTSD) and treatment-resistant depression in accordance with Therapeutic Goods Administration (TGA) regulations.
For Louise McLean FPS, co-owner of Capital Chemist Southlands, the milestone followed a lengthy approval process.
‘It was 12 months from when we received the phone call from the psychiatrist to say they were ready to submit their TGA Authorised Prescriber application until we dispensed the first prescription,’ she said.
[caption id="attachment_12027" align="aligncenter" width="500"]
Owner of Canberra's Capital Chemist Southlands Louise McLean MPS.[/caption]
‘But it was very rewarding to be able to be part of offering patients a new treatment option.
‘As a pharmacist, I have always wanted to make treatments more accessible for patients who need them.
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.’
Compliance is key
Psychiatrists must obtain TGA Authorised Prescriber status to work with a patient under the new treatment pathway. They then work in conjunction with a licensed pharmacist to arrange medicine supply.
‘I’ve worked closely with the psychiatrist we’re assisting for some time with medical cannabis and ketamine-assisted psychotherapy,’ Ms McLean said. ‘He is passionate about psychedelic medicine and novel therapies for PTSD and treatment-resistant depression.’
‘Psychedelics are part of modern medicine, and we can see how patients will benefit.'
Louise McLean FPS
Ms McLean, a member of the Australian Medicinal Cannabis Association who has extensive experience managing cannabis prescriptions, said pharmacists considering involvement in psychedelic supply must be prepared for detailed compliance work.
‘You need an appetite to do the hard work involved in ensuring that all the legislative and regulatory requirements are followed,’ she said.
‘I began by contacting the TGA directly and spoke to our territory’s Health Protection Service (HPS) at length.
‘It’s imperative to include your team, who are integral to the success of the service. I am extremely fortunate to have exceptional staff.
For pharmacists in the ACT, handling MDMA and psilocybin requires compliance with the Medicines, Poisons and Therapeutic Goods Act 2008 and the Therapeutic Goods Regulation 2008. In addition, a Schedule 9 Licence is required to obtain and possess prohibited substances. These are also classified as prohibited substances under the Commonwealth Criminal Code.
‘In our case, we [also] needed to obtain a Medicines, Poisons and Therapeutic Good Licence from the Health Protection Service (HPS) in the ACT to obtain and possess MDMA and psilocybin capsules,’ Ms McLean said. ‘That took 5 months and HPS were supportive throughout the process.’
While some jurisdictions, such as Victoria, require a specific S9 licence, state or territory approvals are still required along with the TGA regulations.
Dispensing psychedelics safely
Before supplying psychedelic medicines, pharmacists need the psychiatrist’s TGA Authorised Prescriber approval paperwork on file to be able to order the medicine.
An additional requirement for prescribing and dispensing of MDMA or psilocybin within the ACT is Chief Officer Health approval specific for the individual patient and prescribed substance.
Patients are not permitted to handle the medicine outside supervised treatment sessions, and strict eligibility criteria must be met before therapy commences.
‘We dispense per treatment session,’ Ms McLean said.
‘Either the doctor collects it from the pharmacy, or we hand-deliver it to his private practice.
‘From our perspective, it’s about ensuring we’re following all licence requirements and having confidence that the doctor is practising legally and ethically.’
The cost of prescribed psychedelics ranges from $100–200 per capsule, with several potentially required per session depending on the dose. The medicines are not listed on the Pharmaceutical Benefits Scheme (PBS), although the Department of Veterans’ Affairs may fund treatment for eligible patients.
Capital Chemist Southlands works closely with a single supplier for both the MDMA and psilocybin capsules, with signature required upon courier delivery.
Stock management also requires care.
‘An MDMA bottle may contain 25 or 50 capsules and demand is, at this stage, very small. We’ve only dispensed it twice for a single patient, with their first treatment in January.’
Managing patient enquiries
Some patients with PTSD and treatment-resistant depression have enquired about alternative treatments, Ms McLean said.
‘It’s not appropriate for us to recommend [these specific treatments],’ she said. ‘If patients specifically ask about these novel therapies, our role is to have a general conversation and refer them to their doctor.’
For Ms McLean, the experience reflects the evolving scope of contemporary pharmacy practice – grounded in compliance, collaboration and patient-centred care.
Pharmacists may wish to contact the relevant state and territory health departments and/or refer to the MDMA and psilocybin hub on the TGA website. See the list of contacts for state/territory medicines & poisons regulation units.
For more information on MDMA and psilocybin complete the AP CPD 'The therapeutic potential of psychedelics'.
[post_title] => What’s involved in dispensing prescribed psychedelics?
[post_excerpt] => An ACT pharmacy became the first to manage psychedelics for PTSD and treatment-resistant depression in accordance with TGA regulations.
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[post_content] => Adrenaline (epinephrine) nasal spray (neffy) was recently approved by the Therapeutic Goods Administration (TGA) and is now available for use in Australia.
The launch of the product marks the first time in over 30 years that a new way of administering adrenaline has been approved in Australia.
So how useful will having a new dose form be? The answer isn’t clear – but the reaction has been positive.
Professor Connie Katelaris AM, a leading NSW allergist welcomes the additional option for care:
‘Anaphylaxis is a difficult condition to manage, with some patients reporting challenges. neffy has been available for some time overseas and now patients in Australia will have access.’
AP explores its place in therapy and whether it’s worth the price.
How does the nasal spray differ from EpiPen?
Similar to EpiPen, neffy delivers adrenaline, the active ingredient used to treat anaphylaxis, a spokesperson for CSL Seqirus, the manufacturer of the medicine, told AP.
‘[However it] doesn’t contain a needle and doesn't require an injection.’
[caption id="attachment_31382" align="aligncenter" width="500"]
Supplied by CSL Seqirus[/caption]
Using a similar delivery device as opioid reversal medicines, the nasal spray administers adrenaline via the nasal mucosa, enabling rapid absorption into the bloodstream.
Can it be placed in a resuscitation kit?
Yes, and no.
While neffy contains adrenaline and is indicated for the same purpose as injectable adrenaline normally kept as part of a resuscitation kit, there is a key difference.
‘Resuscitation kits generally stock items that are Schedule 3, and neffy is currently a Prescription only (Schedule 4) medication,’ the CSL spokesperson said.
Who is the nasal spray best suited to?
Adrenaline (epinephrine) nasal spray is indicated for emergency treatment of anaphylaxis in patients aged 4 years and older and weighing 15 kg or greater, offering an alternative administration route for those who may be needle-phobic – particularly young children.
The medicine comes in two strengths:
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[post_content] => Early monitoring, sensitive communication and guideline awareness are essential when medicines are used to manage youth mental health.
Almost two in five (around 40%) of Australians aged 16–24 years experience a mental disorder in any given year, with depression and anxiety frequently emerging during adolescence and early adulthood.
Despite clinical guidelines recommending psychological therapies such as cognitive behavioural therapy (CBT) as first-line treatment, antidepressants can be prescribed before CBT practice, said Ms Lily Pham MPS, a lecturer at the University of Sydney – who is presenting at the upcoming PSA webinar Antidepressants and adolescents – what every pharmacist should know.
‘Pharmacists often get prescriptions for antidepressants where a young person hasn't received CBT yet – particularly if they’re on a waiting list to receive CBT,’ she said. ‘Antidepressants are typically recommended to be used for 6–12 months before deprescribing should be considered. But we’re finding that doesn’t happen a lot of the time.’
There’s often a gap between guideline recommendations and what pharmacists actually encounter in day-to-day practice. So initiating conversations about treatment planning requires both confidence and clarity.
‘It’s about being able to engage in those conversations and also knowing what to do when you gain that information,’ Ms Pham said.
Bridging the gap when CBT is delayed
Conversations around mental health require careful attention to privacy and tone.
‘It’s important not to use judgmental language,’ Ms Pham said. ‘We might engage in conversation by saying, “I’m just going to ask you a couple of questions about this medication – would you feel comfortable with that?’
Explaining intent can reduce defensiveness and reframe the conversation as supportive rather than interrogative.
‘If you say, “The reason I'm asking is because I want to be able to give you information about the medication that's tailored to you” for example, it can often open up the conversation better,’ she said.
When sensitive topics, including mental health, are discussed, there should always be the option to move into a consultation room.
Pharmacists can also use simple, open-ended questions to explore whether broader treatment planning has been discussed.
‘It comes down to signposting,’ Ms Pham said. ‘You could ask, “is this the first time you’ve used this medication?” And then you might follow with, “When people start this medication, their GP can sometimes have conversations about other strategies, like CBT. Is that something you’ve discussed with your GP?”’
Given much antidepressant use in adolescents is off label, product information doesn’t clearly outline use in younger populations.
‘This is where guidelines specific to prescribing for younger people should be considered,’ she said.
Where clarification with the prescriber is required, young people should not be excluded from the process.
‘Young people often feel very disempowered within the healthcare system, so it’s important that health professionals support young people to have a voice in their healthcare,’ Ms Pham said. ‘If you are going to have those conversations, make sure you also include that young person. That might include saying, “would you mind if I speak to your GP to clarify XYZ details”, if those details haven't been established through your conversations with the young person.’
Checking duration against intention
Through dispensing histories and repeat supply intervals, pharmacists can prompt gentle check-ins around duration of and response to therapy.
‘If you’ve noticed in your dispensing system that a person has been on an antidepressant for over 12 months, flag a conversation with that young person about how they are feeling on the medication, how their mood is, and whether or not they have discussed with their GP about deprescribing or tapering the dose,’ Ms Pham said.
However, pharmacists should use their clinical judgement when approaching this conversation.
‘You would only really have that conversation if that person was faring well,’ she said. ‘If they say, “My mood’s still not great,” you’re not going to ask if they have decided to consider deprescribing. Instead, you might discuss openness to alternative drug regimens with them and their prescriber.’
Repeat supply also provides an opportunity to check whether appropriate review and deprescribing discussions have occurred.
‘You can flag whether this conversation has occurred using your dispensing system every 6 to 12 months,’ Ms Pham said.
Monitoring efficacy and tolerability
When dispensing antidepressants, pharmacists have the opportunity to monitor for both efficacy and adverse effects – particularly those that young people may feel reluctant to disclose.
‘One of the big ones is around sexual dysfunction,’ Ms Pham said. ‘So it's checking in with those short-and longer- term adverse effects, as well as looking at the efficacy of the medication and the need.’
Monitoring and review are shared responsibilities rather than isolated tasks.
‘There is an onus of responsibility on every member of the multidisciplinary healthcare team when you do come in contact, or you do interact with that young person, to check in,’ Ms Pham said.
Even under 60-day dispensing arrangements, pharmacists retain regular contact with young patients using antidepressants.
‘If the GP checks in with them at every appointment, and then the pharmacist once every 2 months – we can still provide touchpoints in that person’s care. And young people would appreciate being engaged in non-judgemental conversations about their care.’
Learn more about pharmacists’ role in the quality use of antidepressants for teens and young adults by attending the PSA webinar Antidepressants and adolescents – what every pharmacist should know, held on 17 February 2026 at 7.00–8.30 pm AEDT.
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[post_content] => Complex, undiagnosed pelvic pain can often leave patients in awful limbo. Pharmacists can help them understand what drives – and can interrupt – pain.
For some people, severe and chronic pelvic pain persists despite extensive investigations and no confirmed diagnosis of endometriosis. In some cases, pain continues even after surgery to remove endometriosis lesions.
Other people may experience overlapping pain conditions such as bladder pain syndrome, irritable bowel syndrome or musculoskeletal dysfunction.
Without a diagnosis, these people often fall through the cracks – left managing debilitating pain with little clarity, validation or structured care.
‘Early intervention in pelvic pain is crucial to reduce the risk of maladaptation, central sensitisation and the significant social, work-related and mental health impacts of untreated pain,’ according to the Chairperson of Chronic Pain Australia, Nicolette Ellis MPS, a pharmacist.
Even without a confirmed diagnosis, commencing appropriate hormonal therapy and analgesics is recommended, she says. Medicines alone are rarely sufficient, and a pelvic pain physiotherapist is often the most important allied health referral to address muscle overactivity and contributors to persistent pain.
Ms Ellis says chronic pelvic pain is best managed through a team-based approach, where pharmacists, GPs, physiotherapists, psychologists and specialists each address different contributors to the pain experience. Clear communication and shared understanding between disciplines can improve outcomes significantly.
‘Around two in three people with chronic pain experience a secondary mental health condition,’ Ms Ellis says.
‘Catastrophising, rumination and helplessness are very common, especially when patients have been repeatedly bounced around the health system without answers.’
Free pain-specific supports like MindSpot, as well as peer networks such as PainLink helpline 1300 340 357 and Chronic Pain Australia’s support groups, can be invaluable, she says, alongside psychologists with an interest in pain.
Chronic vs acute pelvic pain
Acute pelvic pain typically presents suddenly, says Ms Ellis.
Often, it comes with red flags such as severe unilateral pain, fever, vomiting or rapid escalation, warranting urgent medical review. Chronic pelvic pain, in contrast, develops over months or years. It often follows patterns linked to menstrual cycles, bladder or bowel function, stress or muscle tension.
Many people with pelvic pain also dismiss their symptoms. Ms Ellis says they normalise heavy bleeding, bloating or discomfort, which can delay recognition that these patterns are not normal and require assessment. Chronic pelvic pain is defined as pain persisting for more than 3 months that does not need to occur daily. Pain that occurs on more than 10–15 days per month over a 3-month period is generally considered to meet the criteria.
‘A lack of diagnosis should never limit a clinician’s ability to treat, educate or support a patient in managing their pain.’ Ms Ellis stresses. See overleaf for two interesting case studies on undiagnosed pelvic pain that were not endometriosis.
Box 1 - Referral pathways
Pharmacists seeking help for patients with chronic or unexplained pelvic pain can
refer to:
|
Tahnee Simpson[/caption]
Nicolette Ellis MPS[/caption]
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