What to Know About EndeavorRX, the Video Game to Treat ADHD

We often attribute our waning attention spans to the never-ending barrage of notifications and screen time, but one video game company, Akili Interactive, has created a reality where the opposite is true. The mobile game Endeavor is the only video game cleared by the US Food and Drug Administration as a treatment for ADHD for children in 2020. This week, the company announced that the FDA has extended its label to include older kids and teens up to age 17, meaning all kids aged 8 and older can get a prescription for the video game. 

And while it doesn't have the same official clearance from the FDA, there's also an off-label version of the game for adults.

But does it work? Adults are addressing that question -- and reviewing the entertainment value of the game itself -- on Reddit. One redditor described EndeavorOTC as a "boring Mario Kart" that causes your mind to wander in a way that makes you "practice focusing and multitasking." 

Many patients are still struggling to find ADHD treatment, as the US continues to climb out of a pandemic-era drug shortage potentially made worse by an increase in demand for stimulants like Adderall. For people interested in looking into alternative treatments or complementing activities to improve their attention or focus, trying a video game may be a reasonable next step.

How it works 

EndeavorRX is a 25-minute mobile game meant to be used five times a week for four consecutive weeks. It's meant to train or work your brain in a way that improves your focus or attention through daily exercises. 

Prescription version for kids and teens 

Endeavor says it uses "sensory stimuli and simultaneous motor challenges" that target the attention-centered parts of your brain. In the prescription version for children, the goal of the game is to navigate your character through obstacles while collecting targets. As your attention and performance improves, the game gets a little harder. Parents can monitor their child's progress on the game through EndeavorRx Insight, a companion app.

Prior to its clearance as a treatment by the FDA, a trial survey found that 73% of children reported an improvement in their attention using EndeavorRX, compared to 50% of those who used the control. 

To do a five-minute demo of EndeavorRX, you can download the app for iOS or Android and select the demo option. 

Off-label version for adults 

The adult version is the same concept as the children's version but with an adult interface, according to Akili. It forces you to "target and navigate," but it gives you a "focus score" instead of someone else monitoring your progress through the companion app. The focus score is a measure of how quickly and accurately you can complete a task despite distractions. 

According to Akili, improvements in adult attention were significantly larger than they were found to be in children when the game was tested and cleared by the FDA.

For "best results," the company recommends a six-week period playing the game, then a week's break, followed by another six-week period. 

How to get a prescription and how much it costs 

A health care provider will write a prescription and then a special pharmacy will send you a code. EndeavorRX costs $99 for a 30-day prescription, and you can use your FSA or HSA dollars on it. 

EndeavorOTC costs $25 per month, or $130 per year. This off-label version doesn't require a prescription.

Who might not be a good fit for an ADHD video game 

As ADDitude reported, people with photo-sensitive epilepsy, color blindness or certain physical limitations may not be able to use it. 

But compared to the laundry list of side effects that may come with ADHD medications, some of which are stimulants, side effects of playing the video game are, understandably, much milder. Five percent of people in the EndeavorOTC trial reported a side effect from playing the game, most commonly nausea or headache, according to Akili.