EndeavorOTC

What the service is

EndeavorOTC is a digital therapeutic video game designed specifically for attention improvement in adults with ADHD. Made by Akili Interactive, it is the only FDA-authorized digital therapeutic for ADHD that does not require a prescription. The game targets the core executive function deficits in ADHD by challenging players to complete tasks while filtering out distractions, building stronger attention skills through gameplay that adapts in real time to individual ability levels.

How the treatment works

The service runs as a mobile game on your device, designed for daily play on your own schedule. The gameplay mechanics center on two core challenges: in "Target" mode, you tap when you see a specific target while letting distractions pass by; in "Navigate" mode, you steer a course while avoiding obstacles. The real work happens when you combine both: multitasking to boost attention by doing both simultaneously, which forces your brain to strengthen the connections underlying focus.

The game adapts as you improve. As your skill increases, the difficulty increases accordingly, so you stay challenged rather than bored or overwhelmed. This adaptive difficulty is central to how the game strengthens attention: the challenge curve is designed to work your attention muscles without breaking them.

When you start, you receive an initial Focus Score ranging from 0 to 100, along with a projected target you should reach in roughly six weeks with consistent play. The company states that your target represents the score at which you should see meaningful improvements in real-world ADHD-related symptoms. The company's research shows that users who finish their trial with higher Focus Scores were more likely to see greater improvements in actual ADHD-related symptoms, suggesting the in-game metric correlates with real-world benefit.

The commitment is 50 or more minutes per week for six weeks. That is the standard treatment dose the company guarantees, and if you hit that threshold and do not see improvement in attention, you can request a money-back refund. The service recommends a structure of two "doses" of six weeks each, with a one-week break between them to recharge without losing progress. This dosing structure allows users to pause and recover between intensive periods without losing the gains they have made.

The treatment is designed to integrate into your daily routine without requiring specialist appointments, therapist coordination, or medication management. You download the app, set a schedule that works for you, and play. Unlike traditional ADHD medication, which typically needs monthly or quarterly check-ins with a prescriber, EndeavorOTC requires only your commitment to the play schedule. The game itself monitors your performance through the Focus Score and adapts to keep you in the optimal challenge zone.

What the clinical evidence shows

In clinical trials, 73% of participants reported quality of life improvements overall. Within that group, specific real-world changes included: 60% were better able to complete projects on time, 78% reported increased productivity, 54% were better able to keep track of important items such as their keys and wallet, and 50% were better able to pay attention when interacting with others. Additionally, 83% of participants saw clinical improvements in their ability to focus. The company's measure of this is improvement on the Test of Variables of Attention (TOVA), a computerized test of sustained and selective attention.

The indication, according to the company's site, is for adults 18 years of age and older with primarily inattentive or combined-type ADHD. The game is designed for adults specifically; there is a separate product (EndeavorRx) for children ages 8 to 17.

Regarding safety, the company states that there were no lasting or serious side effects reported in any clinical trials for EndeavorOTC. This is a significant contrast to ADHD medications, which commonly carry side effects like appetite suppression, sleep disruption, and mood changes. While ADHD medications work quickly and some people see results within days, EndeavorOTC requires a longer commitment to treatment; the standard gauge period is six weeks of consistent use.

Pricing and access

EndeavorOTC offers three subscription plans:

• One month at $24.99 per month, billed monthly.
• Six months at $16.66 per month, billed every six months at $99.99 total.
• Twelve months at $10.83 per month, billed yearly at $129.99 total.

All subscriptions renew automatically unless you cancel 24 hours before each renewal date. The money-back guarantee applies if you play 50 or more minutes per week for six weeks and do not see improvement in attention. This is distinct from a typical no-questions-asked refund policy; you have to meet the engagement threshold for the guarantee to apply. The guarantee acknowledges that treatment requires both the game and your active participation; skipping weeks or playing fewer than 50 minutes weekly voids the promise.

The site does not publish whether insurance covers EndeavorOTC or address insurance reimbursement in any way. The price points are designed to be more accessible than many therapy services or long-term medication costs, particularly on the annual plan.

What the service does not disclose

The company does not specify which devices run the game. The site displays "Download on the playstore" and "Download on the appstore" buttons, suggesting availability on both iOS and Android platforms, but does not explicitly state this. You have to download the app to confirm your device is supported.

The company does not state whether you need to create an account or provide personal health information to download or use the app. It does not specify data retention policies for your gameplay data or Focus Score, nor does it detail what happens to your data if you cancel your subscription.

The company does not mention whether the game works for adults with combined-type ADHD who also have anxiety, depression, or other co-occurring conditions. The indication is for ADHD specifically; whether it helps with comorbidities is not addressed.

Who this fits

EndeavorOTC is designed for adults 18 and older who have been diagnosed with primarily inattentive or combined-type ADHD and want to try an option without medication or its side effects. It fits someone who has the time to commit to 50 minutes weekly for six weeks and who is comfortable with a video game as a treatment modality. The subscription cost, starting at under $11 monthly on the annual plan, makes it more affordable than most therapy or many ADHD medications.

It does not fit someone under 18; a separate product, EndeavorRx, is designed for children. It does not fit someone looking for immediate medication or rapid symptom relief; the six-week treatment window is longer than some people need to wait for improvement. It does not fit someone uncomfortable with or unable to use mobile gaming, since the entire intervention is delivered through a game interface on a smartphone or tablet.

The company's emphasis on measurable Focus Score improvement over vague claims about "feeling better" makes it suitable for someone who wants concrete metrics and the accountability of a money-back guarantee if results do not appear after the trial period. If you respond well to games and structured challenges, the gameplay format may feel motivating rather than like clinical work. If you struggle to maintain motivation for a six-week treatment cycle without external pressure or accountability, the structured program with clear metrics may be the support you need.