A New Video Game May Help Treat Adult ADHD. Here's What to Know

As a teacher, 40-year-old Adriana Popa is no stranger to multitasking. One minute she’s teaching class and the next she’s organizing her lesson plans. Her job requires her to pivot her attention quickly, but Adriana faces the additional challenge of having Attention Deficit Hyperactivity Disorder (ADHD), where focus and attention are already hard to maintain.

Medications have helped her and many of the other 4.4 percent of American adults diagnosed with ADHD. But a new treatment may offer additional support. In June, the digital medicine company Akili launched EndeavorOTC — a video game for adult ADHD. The phone app is the first nonprescription video game treatment shown to improve inattention in clinical trials. 

“Before Endeavor, I often struggled to write my lesson plans without getting easily distracted or effectively communicate with more than one student at a time,” explains Popa, who was one of the participants of the video game clinical trial. “As I played the game, I had to focus on one main task and ignore interference, and it has helped me to effectively eliminate distractions and stay focused on my goals at work. Because of this, I have a better system of organization for my classroom and have successfully taken on bigger responsibilities, such as hosting a robotics competition at our school.”

Though the video game is designed specifically for adults with a confirmed ADHD diagnosis, women are often underdiagnosed with ADHD and those with mild attention issues may even benefit from this over-the-counter treatment. Of course, anyone considering trying a new treatment for ADHD should first consult with their healthcare provider. Here’s what to know.

EndeavorOTC aims to be a workout for your brain

EndeavorOTC is a medical device built on the same technology as Akili’s EndeavorRx, the first FDA-approved video game for children with ADHD. “It’s a treatment that is sort of disguised as a video game,” says Dr. Scott Kollins, a clinical psychologist at Duke University School of Medicine and Akili’s chief medical officer. 

The video game is designed to exercise brain areas involved in attentional control, an area behind some of the challenges people with ADHD face.

There are two main parts to the game. One is a navigation component where you control a character following a path that gets increasingly more difficult. Along the way, you are using the phone or tablet to steer the avatar towards power zones that boost your speed while avoiding distracting obstacles such as creatures flying at you. Another component is knowing when to divert your attention. For example, you are supposed to respond to some of the monsters while others you are instructed to ignore. 

The video game is recommended for 25-minute gameplay a day, five days a week. Though Dr. Kollins notes users can still benefit even if they play it for only a few minutes a day.

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Over 80 percent of trial participants saw an improvement in focus

EndeavorOTC is one of the few video games tested in a clinical trial. The trial took place in 15 sites across the United States with 221 adults over 18 with a diagnosis of inattentive or combined-type ADHD. People ranged from 18 to 70 years old.

All the participants were instructed to play the video game at home for 25 minutes 5 days a week for a total of six weeks. Approximately 40 to 50 percent of participants were on medication, says Dr. Kollins. People taking medication for ADHD or other psychiatric conditions could continue taking it as long as they stay stable. “We didn’t want them changing their medicine because if they change their medicine in the middle of the study, it’d be hard to tell if any changes were related to change the medicine or what was happening with treatment.”

People were each given a focus score ranging from 0 to 100. After 6 weeks of gameplay, they were tested again and all showed improvements in their ability to stay attentive. Endeavor reported that 83 percent of participants saw clinical improvements in their ability to focus. Over one-third of the volunteers said they felt they had better attentional control. 

The improvement in attention translated to a better quality of life for 73 percent of trial participants, according to the company. Of these, 60 percent said they could better hit project deadlines and 53 percent were more efficient multitaskers.

What to know if you’re considering trying EndeavorOTC

Dr. Marcy Caldwell, a psychologist specializing in adult ADHD in Philadelphia, finds the new video game promising and an appealing way to get people to take their treatment. “Who wouldn’t want to play a video game instead of a pill that’s going to impact your sleep and appetite,” she says. “I love that people are looking outside the standard parameters of what we think of as treatments.”

While the video game is one treatment she is considering recommending in her own practice, she does have some reservations about the research findings. The most concerning is that all of the research is produced by the company instead of independent researchers who have a stake in producing positive results. She recommends more independent research to have some type of cross-validation. “It is going to take a little bit more time before there’s a wider acceptance of it.”

One interesting detail in the clinical trial was that 70 percent of enrollees were women. An observation Dr. Kollins hypothesizes might stem from the challenges women with ADHD face in getting a diagnosis. While ADHD is typically diagnosed in childhood, women are more likely to receive a diagnosis later in life because they exhibit fewer outward-facing symptoms. Another explanation is that video games are a more attractive option for women who are pregnant or breastfeeding and who are worried about the side effects of medication.

That being said, the video game is targeted at adults with ADHD. However, since it does not require a prescription to play, it is possible it could benefit undiagnosed women. “We’ve already seen reviews come in on the App Store from people saying they don’t have ADHD, but [are] finding the game helpful,” says Dr. Kollins. 

The game is also more affordable for people without insurance and can be used in the comfort of your home, adds Dr. Caldwell. “Women are a group of people who often have more barriers to care. This will be a useful supplement.”

You can download EndeavorOTC on the Apple store with several pricing models and yearly subscriptions. Android users can sign up for Akili’s mailing list to get notified when it becomes available.

“We have not really changed the way we treat ADHD in decades with medication and behavior therapy, being the two frontline treatments,” adds Dr. Kollins. “Now we have a new alternative.”

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