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Doctor-prescribed videogame for ADHD

endeavorrx.com

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Re: Doctor-prescribed videogame for ADHD

#41

Post by Aurornis »

api wrote: post #33
ben_sisko wrote: post #29

Stimulant medication for ADHD has the highest effect size in all of psychiatry. ADHD is highly treatable, when people are properly treated. This just feels like something that somebody made for the parents who are pathologically drug averse at the expense of their children. Of course, the parents don’t realize that their kids don’t get that development time back, so the longer they wait, the harder things can get for…

Our stupid phobia of stimulants is a major blocker too. Making it hard to get ADD drugs does nothing to address abuse of street drugs like meth. Unlike opiates there is no evidence they lead people toward street drugs. I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal.

One of my friends works in the rehab field. Prescription stimulants are a common starting point for a lot of younger kids entering their programs right now.

One of the major problems is some primary care doctors and nurse practitioners have started prescribing stimulants to anyone who requests them. Even worse, some of these people are prescribing unreasonably high doses (some times 2/3rd of the maximum allowable dose are given to small teens as their starting dose, which is absolute insanity).

It’s not just pointless fear mongering. These drugs are very popular recreationally among high school and college students and prescriptions are often sought to allow them to drink more alcohol for longer into the night.

Re: Doctor-prescribed videogame for ADHD

#42

Post by superb_dev »

From the website, I’m not clear on how this is actually working. (On the assumption it’s working at all, I have not read the research)

The FAQ says “EndeavorRx uses sensory stimuli and simultaneous motor challenges designed to target areas of the brain that play a key role in attention function.”

So is it just meant to exercise those areas? “Uses sensory stimuli and simultaneous motor challenges” could describe a million other games.

Re: Doctor-prescribed videogame for ADHD

#43

Post by piperswe »

ProjectArcturis wrote: post #40
api wrote: post #33

Earlier quoted context omitted.

Our stupid phobia of stimulants is a major blocker too. Making it hard to get ADD drugs does nothing to address abuse of street drugs like meth. Unlike opiates there is no evidence they lead people toward street drugs. I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal.

>I’m personally in favor of OTC availability of some kind of safe abuse resistant mild stimulant. Sure there are a few people who would try to get high with it but hard liquor and weed are legal. Like caffeine?

Caffeine builds physical dependence easier than amphetamine, AFAIK

Re: Doctor-prescribed videogame for ADHD

#44

Post by ProjectArcturis »

ryanwhitney wrote: post #19
diob wrote: post #12

You know when they don't say actual numbers that it doesn't work much better than a placebo.

They include some clinical research info at the end of the usage instructions PDF[0]. One says results were not statistically significant and the other has a warning that it may be placebo effect since they didn’t have a “sham control group”. (I don't have enough stats knowledge to know what any of this actually means though.) 0: https://www.endeavorrx.com/wp-content/uploads/2024/01/Endeav... (pdf)

In their largest study, they found that 4 weeks of treatment improved ADHD scores by 1 standard deviation, and this was highly significant. That's the equivalent of going from the 5th percentile to the 35th - definitely a meaningful improvement.

Re: Doctor-prescribed videogame for ADHD

#46

Post by kevinh »

Zambyte wrote: post #30
umbra07 wrote: post #10

I've been on this for about a month and a half now. The game itself isn't engaging at all. It was a struggle to get myself to actually play the game regularly, for the allotted time (30 minutes, 5 days a week). It feels like a pretty big flaw with the game - after all, one of the challenges that people with ADHD face is forcing themselves to do things they don't want to do. This game is a complete bore, and I can't i…

> This game is a complete bore, and I can't imagine anyone over, idk, 10 feeling differently. FWIW, from their FAQ (and several other places on the site): > EndeavorRx is indicated only for children ages 8-12 years old with primarily inattentive or combined-type ADHD who have a demonstrated attention issue.

The FAQ does indeed say that it's for children ages 8-12 years old, but the main page says the following:

> EndeavorRx improves attention function in children 8‑17 with ADHD.

I went back to look at older versions of the site, and some of the references have changed from 12 to 17, but not others. I assume that they ran another study with a higher upper limit later, but didn't update their site everywhere.

Re: Doctor-prescribed videogame for ADHD

#47

Post by ProjectArcturis »

odo1242 wrote: post #35
ryanwhitney wrote: post #19

Earlier quoted context omitted.

They include some clinical research info at the end of the usage instructions PDF[0]. One says results were not statistically significant and the other has a warning that it may be placebo effect since they didn’t have a “sham control group”. (I don't have enough stats knowledge to know what any of this actually means though.) 0: https://www.endeavorrx.com/wp-content/uploads/2024/01/Endeav... (pdf)

As a person who did study statistics, they found absolutely nothing useful, for the most part, if what you say is correct. (Basically, everything they found can be attributed to random chance, and there’s no proof their game is anything special compared to other games)

Did we read the same thing? "The primary endpoint was achieved, mean change from baseline on the TOVA API was 0.93 in the EndeavorRx group versus 0.03 in the control group (p=0.006). "

Re: Doctor-prescribed videogame for ADHD

#48

Post by gcheong »

ProjectArcturis wrote: post #37
gcheong wrote: post #15

Earlier quoted context omitted.

FDA did not approve it, that is the highest level and requires proof that it is more effective than placebo I believe. The FDA only looked for adverse events in the data and granted authorization to market it as they determined it is very low risk for adverse events. But people will be mislead by the FDA-authorized status as some kind of FDA blessing that it works: https://www.fda.gov/news-events/press-announcements/…

This is false. The FDA does not grant approval to market anything solely on the basis of "low risk for adverse events." The game makers had to run studies demonstrating that it improved ADHD measures. The link you provided says that as well: "The FDA reviewed data from multiple studies in more than 600 children, including studies that evaluated, among other things, whether participants demonstrated improvements in at…

Fair enough, I think I came to that conclusion because reading the next statement was just that they determined there were no major adverse events. But I think it still stands that this is only a marketing authorization, the FDA isn't saying it works, so really the company shouldn't be mentioning the FDA at this point unless they go for a stronger classification.

Re: Doctor-prescribed videogame for ADHD

#49

Post by superb_dev »

autoexec wrote: post #28

I'm extremely skeptical. I've yet to see a treatment for ADHD that is only effective on children 8-17. If their product actually worked, I'm sure they wouldn't want to exclude the massive market of adults with ADHD. I'm also opposed to any medical device that uses a cell phone or requires a download from an app store. At that point you're handing over at least some amount of medical information to an ad company, usin…

Wait, how isnt that privacy policy terrible? No medical treatment should also be selling your behavior to advertisers.

Re: Doctor-prescribed videogame for ADHD

#50

Post by antisthenes »

stevebmark wrote: post #8
the_gipsy wrote: post #3

$99 a month subscription, because they're FDA or whatever approved. Is there corruption with these kind of things, or did they just hit jackpot?

There is high corruption at every level of healthcare, from ambulance companies to prosthetists to local doctors to hospitals to pharmacies to insurance to government. $99/month is pure corruption, and they get away with it because insurance can help cover it. In healthcare, "Economies of scale don’t lower prices", and "prices rise to what the market will bear" - An American Sickness. Very much what you're seeing her…

Well said.

This corruption costs Americans hundreds of billions of dollars every year.

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