Prior to treating pediatric patients and adults with CNS stimulants, including QuilliChew ER, assess for risk of abuse as well as the presence of cardiac disease (ie, perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam) and risk for abuse. The recommended starting dose is 20 mg given orally once daily in the morning. Dosage may be increased or decreased weekly in increments of 10 mg, 15 mg, or 20 mg per day. Daily dosage above 60 mg is not recommended. Reduce dosage or discontinue therapy if patients exhibit paradoxical aggravation of symptoms or other side effects, or if improvement is not observed after an appropriate dose adjustment over a 1-month period.