Key Takeaways
GPs can continue, not always start. Dutch general practitioners may prescribe methylphenidate, typically as continuation after specialist initiation.
Paperwork helps but isn’t decisive. A diagnosis letter and dosing history are useful; a Dutch prescriber still decides under local law and guidance.
EU vs. non-EU paperwork. Cross-border prescription rules aid movement within the EU/EEA; they don’t validate prescriptions from outside the bloc.
Travel needs certificates. Controlled-medication rules require official documents when crossing borders; the government and CAK outline the steps.
Story & Details
How the system frames ADHD medicines
In Dutch care, adult ADHD diagnosis and treatment initiation generally sit with specialist mental health services. Once a patient is stable, the GP may continue prescribing within a shared-care understanding. Guidance for primary care explicitly addresses adults already using ADHD medicines and offers practical checklists for monitoring, dose stability, and follow-up.
What GPs can do—and why some still say no
Methylphenidate is on the controlled-substances lists under national law. That legal status raises the bar on prescribing, dispensing, and monitoring. A GP who hasn’t initiated treatment may reasonably ask for local assessment, specialist correspondence, or a shared-care note before taking over. The result: many GPs continue prescriptions, especially with solid documentation and stable dosing; not all will, and none are obliged to.
The role of your documents
Bring a clear packet: diagnosis letter, dosing regimen, treatment response, adverse-effects history, and contact details for the originating psychiatrist. These documents inform Dutch clinical judgment; they do not compel a prescription. The prescriber must issue a Netherlands-valid prescription and ensure monitoring aligns with domestic standards.
Crossing borders with a prescription
Within the EU/EEA, a prescription written in one member state can be presented in another, but medicines may differ in brand name or availability. Pharmacies rely on international (generic) names. This framework does not extend to prescriptions from outside the EU/EEA, which generally must be re-issued locally.
Traveling with controlled medication
For Opium Act medicines such as methylphenidate, travelers need official certificates. Within Schengen, that is the Schengen medication certificate; for non-Schengen destinations, a medical certificate is required. Government pages explain which form applies and how to obtain it, and the CAK provides the destination-specific details.
What the CAK actually is
The Centraal Administratie Kantoor (CAK)—literally Central Administration Office—is a Dutch government agency that handles administrative healthcare tasks. It issues Schengen medication certificates for people who need to travel with controlled substances, manages certain healthcare contributions, and provides official information about which medicines fall under the Opium Act.
In practice, when a traveler needs proof to carry methylphenidate legally abroad, the CAK is the office that validates and processes those documents.
The European Medicines Agency’s role
The European Medicines Agency (EMA), based in Amsterdam, oversees the evaluation and supervision of medicines across the European Union. It ensures that all approved medicines meet consistent EU-wide standards of safety, quality, and effectiveness. The EMA coordinates expert scientific reviews, monitors side effects, and informs the public about medicines’ benefits and risks.
Its educational video—linked below—explains how EU-level regulation maintains trust and consistency in drug safety, including for ADHD treatments such as methylphenidate.
Safety, monitoring, and why it matters
Regulators and pharmacovigilance centers continuously track adverse-event signals for ADHD medicines, including in adults. This ongoing surveillance explains the emphasis on careful initiation, structured follow-up, and clarity when switching products or formulations.
Conclusions
A practical way to move forward
Start with an intake at a nearby practice. Lead with continuity: diagnosis letter, dosing, stability, and willingness to attend a local assessment or see a specialist. Expect a measured pace—sometimes a referral first—then GP continuation if criteria are met.
The soft landing most people want
When paperwork is clear and treatment is steady, many practices will take over prescribing with routine monitoring. It’s careful, not cold. And it works.
Sources
- Dutch College of General Practitioners (NHG). Aandachtspunten bij patiënten ≥ 18 jaar die ADHD-middelen gebruiken (guidance for GPs seeing adults already treated). https://richtlijnen.nhg.org/files/2023-09/Aandachtspunten-bij-pati%C3%ABnten-18-jaar-die-ADHD-middelen-gebruiken-230912.pdf
- Richtlijnendatabase (national guideline platform). Medicamenteuze behandeling ADHD – volwassenen (Recommendations). https://richtlijnendatabase.nl/richtlijn/adhd_bij_volwassenen/medicamenteuze_behandeling_adhd/aanbevelingen_adhd_bij_volwassenen.html
- Richtlijnendatabase. ADHD bij volwassenen (overview). https://richtlijnendatabase.nl/richtlijn/adhd_bij_volwassenen
- Government of the Netherlands. What do I need if I take my medication outside the Netherlands? https://www.government.nl/topics/travelling-outside-the-netherlands/question-and-answer/what-do-i-need-if-i-take-my-medication-outside-the-netherlands
- Government of the Netherlands. Can I take my medication abroad? https://www.government.nl/topics/medicines/question-and-answer/can-i-take-my-medication-abroad
- CAK (Centraal Administratie Kantoor). Welke medicijnen vallen onder de Opiumwet? https://www.hetcak.nl/medicijnen-mee-op-reis/veelgestelde-vragen/welke-medicijnen-opiumwet/
- Wetten.nl (official law database). Opiumwet. https://wetten.overheid.nl/BWBR0001941/
- Wetten.nl. Opiumwetbesluit (lists include methylfenidaat). https://wetten.overheid.nl/BWBR0014405
- European Commission — Your Europe. Presenting a prescription in another EU country. https://europa.eu/youreurope/citizens/health/prescription-medicine-abroad/prescriptions/index_en.htm
- Netherlands Pharmacovigilance Centre Lareb. Overview of reports on methylphenidate in the Netherlands (adult context). https://www.lareb.nl/Knowledge/FilePreview?id=44786&p=1422
- European Medicines Agency (YouTube). How does EMA ensure the safety of medicines in the EU? https://www.youtube.com/watch?v=V9TN8nrbGOg
Appendix
General practitioner (huisarts). The community doctor who coordinates most routine medical care in the Dutch system; may continue specialist-initiated treatment when appropriate.
Methylphenidate. A stimulant used in ADHD; in the Netherlands it is a controlled medicine governed by the Opium Act, with extra rules for prescribing and travel.
Opium Act (Opiumwet). Dutch legislation regulating narcotic and psychotropic substances; it sets special requirements for prescribing, dispensing, and transporting controlled medicines.
Shared care. A model where a specialist initiates and stabilizes treatment and the GP continues prescribing and monitoring under agreed responsibilities.
Cross-border prescription (EU/EEA). A prescription written in one EU/EEA country that may be dispensed in another, subject to national availability and identification rules.
Schengen medication certificate. An official document allowing travelers to carry certain controlled medicines within Schengen; the CAK and government pages explain how to obtain it.
Centraal Administratie Kantoor (CAK). The Central Administration Office of the Netherlands, a public institution responsible for several healthcare administration tasks, including issuing travel certificates for controlled medicines and advising on Opium Act compliance.
European Medicines Agency (EMA). The EU body based in Amsterdam that evaluates and supervises medicines. It ensures that all approved drugs meet safety, quality, and efficacy standards across member states and maintains the public database and educational resources on medicine safety.
My Diary - Leonardo Cardillo 