Prior to treating children, adolescents, and adults with CNS stimulants, including QuilliChew ER, assess each patient’s risk for abuse, misuse, and addiction. Assess for the presence of cardiac disease (ie, perform a careful history, family history of sudden death or ventricular arrhythmia, and physical exam). Assess the family history and clinically evaluate patients for motor or verbal tics or Tourette's syndrome. 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.