If you’re weighing aducanumab and feel unsure, you’re not alone. Aducanumab (Aduhelm) brought a lot of debate—some patients saw modest benefits, others faced brain swelling or couldn’t access the drug. Fortunately, several alternatives exist, from other antibody therapies to standard symptom-focused drugs and trial options. This page helps you compare realistic choices so you can ask smarter questions at clinic visits.
Monoclonal antibodies targeting amyloid: lecanemab, donanemab, and gantenerumab are the closest alternatives. Lecanemab showed clearer cognitive benefits in a large phase 3 trial and is approved in some places; it still carries a risk of ARIA (brain swelling or bleeding) but may slow decline more reliably than aducanumab. Donanemab showed promising early results for patients with specific plaque profiles and is moving through approvals. Gantenerumab is in advanced testing and may be an option inside trials. Ask your neurologist about amyloid PET scans or blood tests to see if you match trial criteria or approved use.
Symptom-management drugs remain essential. Cholinesterase inhibitors—donepezil, rivastigmine, galantamine—help memory and daily function for many people with mild-to-moderate Alzheimer’s. Memantine helps with moderate-to-severe cases by reducing excitotoxicity. These drugs don’t remove amyloid, but they’re widely available, relatively cheap, and have predictable side effects. Combining symptom drugs with a disease-modifying approach is common in practice.
Clinical trials are a practical route if approved options aren’t right for you. Trials test new antibodies, vaccines, small molecules that target tau, inflammation, or metabolism. Joining a trial gives access to cutting-edge care and close monitoring, but read the consent form carefully: some trials require frequent scans, lumbar punctures, or strict clinic visits. Use clinicaltrials.gov or local Alzheimer research centers to find studies near you.
Non-drug strategies matter. Exercise, structured cognitive activities, better sleep, and heart-healthy diets, and treating blood pressure and diabetes all slow decline and improve daily life. These approaches don’t replace medications but often boost quality of life and reduce hospital visits. Ask for a practical plan you can stick to—short walks, routine sleep times, and simple memory exercises make a difference.
Safety and access tips: monoclonal antibodies need infusion centers and MRI monitoring for ARIA. Check insurance coverage, infusion costs, and travel time. If cost is a barrier, ask about manufacturer assistance programs or clinical trials that cover visits. Also, get a second opinion from an Alzheimer specialist or memory clinic if you feel unsure about risks and benefits.
Bring a simple checklist: what results can I expect, what are the risks of ARIA, do I need PET or blood tests, how will treatment affect daily life, what are costs and coverage, and are there local trials I qualify for? Write answers down and bring a caregiver to appointments.
Bottom line: if aducanumab feels risky or out of reach, you still have options—other antibodies, standard symptom drugs, trials, and lifestyle fixes. Talk openly with your care team, get the scans and labs you need, and prioritize what matters most for day-to-day life.
In 2025, there are several viable alternatives to Aducanumab for treating Alzheimer's. This article discusses six options, including Donepezil, which increases acetylcholine levels, and Lecanemab, known for its antibody targeting Alzheimer's plaque. The pros and cons of each alternative are considered, offering a comprehensive comparison for those exploring treatment choices.
