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updated: 6/22/2020 10:14 AM

Constable: Prescription ADHD video game 'needs study,' doctor says

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Children struggling with attention deficit/hyperactivity disorder often take drugs such as Ritalin or Adderall. Now, doctors can write those kids a new prescription -- for a video game.

But Dr. Joseph F. Hagan Jr. of the American Academy of Pediatrics in Itasca says the video game is not a game-changer and needs more study.

This week, for the first time, the U.S. Food and Drug Administration approved a video game as a therapy for a health condition. The game, called EndeavorRx and made by Akili Interactive, is targeted at children from the ages of 8 to 12 with specific forms of ADHD. It looks similar to other video games, with a variety of characters moving through interesting landscapes.

"This is a somewhat surprising approval," says Hagan, vice chair of the academy's subcommittee on children and adolescents with ADHD and co-author of last year's revised guidelines on the subject. Hagan notes the research relied on a variety of small studies with modest results on a total of more than 600 children.

"I wish the numbers were 6,000-plus and not 600-plus," Hagan says. "I'm not going to recommend it to my families because I don't think it's ready for prime time. I think it deserves additional study."

Akili Interactive notes EndeavorRx is supplemental, not a replacement for drugs and therapies that have shown to be effective. "With EndeavorRx, we're using technology to help treat a condition in an entirely new way as we directly target neurological function through medicine that feels like entertainment," Akili CEO Eddie Martucci said in a news release.

"The question is, 'How useful is this addition?'" Hagan said.

Dr. Jeffrey Shuren, director of the FDA's Center for Devices and Radiological Health, said in a news release: "The EndeavorRx device offers a non-drug option for improving symptoms associated with ADHD in children and is an important example of the growing field of digital therapy and digital therapeutics. The FDA is committed to providing regulatory pathways that enable patients timely access to safe and effective innovative digital therapeutics."

The characteristics of ADHD were first described in the mid-1800s, and ADHD is a relatively common disorder today. ADHD affects about 4 million children ages 6 to 11. Symptoms can include difficulties focusing and paying attention, problems controlling behavior, and very high levels of activity.

Hagan notes that prescription drugs, and sometimes combinations of different drugs, along with therapy have been proven to improve life for children with ADHD. He adds that some people even can turn elements of ADHD into "an advantage" as they age.

"Why did Dennis Rodman get so many rebounds?" Hagan says of the high-energy and controversial NBA star who won three championship rings with the Chicago Bulls in the 1990s and was hailed as a role model by ADHD advocates.

Treating ADHD with methylphenidate stimulant drugs has been an established first-line treatment since the FDA approved it in 1955. Doctors have plenty of data about how effective those are, as well as the long-term effects.

We don't know the long-term effects of using video games as an ADHD treatment, Hagan says. A decade ago, some now-discounted studies suggested screens contributed to ADHD. Now the FDA's ruling that one video game can help with treatment should spur more research.

"I'm thinking this is interesting," Hagan says, noting parents and teachers are keys to most treatment.

"Any additional help kids can get, families are going to want. I'm glad they are doing this research."

The game costs $350.

"I think I'd spend that on a babysitter," Hagan says, "so parents can get some rest and come back strong."