The rising tide of ADHD diagnoses, along with supply chain disruptions and manufacturing challenges, have led to a severe shortage of Adderall and other medications typically used in managing attention-deficit/hyperactivity disorder (ADHD).
In the face of this shortage, both healthcare providers and patients are increasingly turning to non-pharmacological treatments to potentially augment or supplant conventional therapies involving central stimulants.
The effectiveness of cognitive training in addressing attention deficits has long been a topic of robust debate within the neuroscience community, with results varying from inconsequential to surpassing those of pharmacological interventions. Recent years, however, have seen a consensus emerging within the scientific community, incorporating a deeper comprehension of the conditions necessary to stimulate enduring enhancements in working memory and attention.
Central stimulants such as Adderall have demonstrated their efficacy in curbing symptoms of hyperactivity. However, a number of recent clinical studies have shown that at least one digital intervention, Cogmed, has the capacity to outperform medication when it comes to improving working memory and attention.
“We’re not advocating for people to abandon medication that works for them, but what we can offer is a complement that can enhance overall therapeutic results. Especially for those who can’t tolerate the side effects of central stimulants, we provide an option,” says Cogmed CEO Carl Hamilton.
In the realm of cognitive and mental disorders, various digital offerings have demonstrated convincing efficacy, benefitting both individual patients and health economics broadly. Still, their market share remains minuscule in comparison.
One contributing factor is undoubtedly the naturally cautious disposition of the healthcare sector, which prudently favors a gradual approach when integrating new treatments. Furthermore, insurance providers have been tardy in incorporating digital treatments into their coverage.
Hamilton of Cogmed suggests another factor:
“An intervention like this, it’s more demanding, both on the patient and the provider side. It’s not about being digital – it’s about the fact it’s a training regimen. Just like with a rehab program you get from your physiotherapist, you will need to invest intensity, frequency, and persistence to see results. That’s where taking a pill always will seem simpler, whether you’re the one prescribing or taking them.”
This highlights a further predicament inherent in digital therapeutics: patient compliance. Most people, especially those living with ADHD, need ongoing encouragement and reminders to successfully complete a cognitive training program. Such an approach aligns well with the working methodology of a clinical psychologist or therapist, but falls beyond the conventional duties of a general practitioner or pediatrician. Traditionally however, psychologists are mostly involved in assessment and diagnosis, while the treatment is more often dealt with by the medical profession, which raises the question of which profession is best suited to adopt this kind of intervention.
Aside from its broader accessibility compared to medication, cognitive training offers another compelling advantage: its effects appear to persist, and possibly even intensify, after treatment concludes. A recent German study observed 300 schoolchildren undertaking the Cogmed training program during regular school hours and 300 who did not. Immediate effects were noted in areas such as working memory and attention. Notably, four years after the intervention, those who underwent working memory training at the tender age of six demonstrated a more than 50 percent increased likelihood of enrolling in advanced middle school programs, compared to their peers in the control group. In the realm of education, it’s rare to encounter an intervention that offers an impact of such remarkable scale and enduring influence.
