Management of S4 medications for Mental Health in General Practice

The Management of S4 Medications: General and Mental Health course is designed to equip general practitioners, pharmacists, and other primary care professionals with the skills to prescribe, monitor, and manage Schedule 4 (S4) medications safely and effectively. The course is structured into five key units, combining clinical case studies, regulatory guidance, and practical resources.

Unit 1 – Mental Health Case Studies with S4 Medications
This unit presents four real-world case studies covering depression, bipolar disorder, anxiety in older adults, and post-traumatic stress disorder (PTSD). Each case highlights common challenges such as drug interactions, adverse effects (e.g., sexual dysfunction, lithium toxicity, benzodiazepine-related falls), and appropriate clinical interventions. Learners gain practical insights into safe prescribing and pharmacist-led strategies for improved patient outcomes.

Unit 2 – What are S4 Medications?
Participants explore the Australian scheduling system regulated by the Therapeutic Goods Administration (TGA). The unit explains the classification of medicines, with a focus on Schedule 4 and Schedule 4D (restricted) drugs. It covers issues of dependency, misuse, trafficking risks, and legal controls. Learners also examine adverse effects, risk prevention strategies, and the importance of adhering to prescribing instructions.

Unit 3 – S4 Medications in Mental Health
This unit discusses the common S4 medications used in mental health, such as benzodiazepines, codeine-based analgesics, gabapentinoids, and sedative-hypnotics. It highlights the GP’s central role in Australia’s mental health system, the importance of collaboration with psychiatrists, and the regulatory responsibilities under the Mental Health Act. Adverse effects, drug dependence, and drug–drug interactions are explored in depth, with an emphasis on safe prescribing practices.

Unit 4 – Mental Health References for Clinicians and Patients
Participants are introduced to key resources supporting safe medication use. References include guidelines from health authorities, safety standards, national titration charts, and practical fact sheets for patients. Emphasis is placed on multidisciplinary collaboration, telehealth integration, and informed decision-making. Patient-focused resources, such as multilingual information leaflets and consumer health websites, are highlighted to support adherence and engagement.

Unit 5 – General References for Clinicians and Patients
The final unit consolidates knowledge with broader references on S4 medication governance, including TGA scheduling, state-specific regulations, and inappropriate medication use in vulnerable populations (e.g., elderly patients). It examines drug–drug interactions, de-prescribing strategies, and reflective questions for practitioners to apply in practice. Learners are encouraged to assess risks, recognise adverse events, and provide evidence-based guidance to patients.