Highlights
- Older medicines can ease symptoms for a time.
- Lecanemab and donanemab are the first treatments to slow early Alzheimer's.
- They work best early and require monitoring for side effects.
- New blood tests are making early diagnosis easier.
For decades, an Alzheimer's diagnosis came with very limited treatment options. The medicines available could ease some symptoms for a while, but nothing could change the course of the disease itself. Families were often told there was little more to be done.
That picture has changed. In recent years, the first treatments that slow the progression of early Alzheimer's disease have been approved, diagnosis has become simpler with new blood tests, and the research pipeline is the largest it has ever been. This article explains the treatments available today, who they're for, their benefits and limits, and what scientists are working on next.
Treatments That Ease Symptoms
These medicines have been used for many years. They don't stop the disease, but they can help with memory, thinking, and daily function for a time in some people.
Cholinesterase Inhibitors
Donepezil, rivastigmine, and galantamine work by boosting levels of acetylcholine, a brain chemical important for memory and learning. They're used for mild to moderate Alzheimer's, and donepezil is also approved for more severe stages. Some people experience modest improvements or a slower decline in symptoms. Side effects can include nausea, diarrhea, and sleep problems.
Memantine
Memantine works on a different brain chemical, glutamate, and is used for moderate to severe Alzheimer's. It's sometimes combined with a cholinesterase inhibitor.
Treatments That Slow the Disease
The biggest breakthrough has been a new class of medicines called anti-amyloid antibodies. These target beta-amyloid, the sticky protein that builds up as plaques in the brains of people with Alzheimer's, and help the immune system remove it.
Lecanemab (Leqembi)
Lecanemab received full approval from the US Food and Drug Administration in 2023. In its main clinical trial, it slowed decline in memory and thinking by about 27 percent over 18 months compared with a placebo in people with early Alzheimer's. It was first given as an intravenous infusion every two weeks. Since then, the FDA has approved less frequent maintenance dosing and an under-the-skin injection form that can be given at home, making treatment more convenient.
Donanemab (Kisunla)
Donanemab was approved by the FDA in 2024. In its main trial, it slowed decline by around 35 percent in people at an earlier stage of disease. It's given as a monthly infusion, and some people can stop treatment once scans show amyloid has been cleared, which shortens the overall course of treatment.
Both medicines have also been approved in a number of other countries, though approval and coverage vary.
Who Can Receive These Treatments?
Anti-amyloid treatments are currently intended for people with:
- Mild cognitive impairment or mild dementia due to Alzheimer's disease
- Confirmed amyloid in the brain, shown by a PET scan, spinal fluid test, or in some cases a blood test
They're not approved for people in later stages of Alzheimer's or for people without symptoms. This is one reason early diagnosis has become so important.
Benefits and Limits
These medicines represent real progress, but it's important to have realistic expectations:
- They slow, not stop or reverse, the disease. People still decline, but more slowly on average.
- The benefit is modest. Experts debate how noticeable the difference is in daily life, though longer-term data suggest the benefit may grow over time.
- They require monitoring. Regular MRI scans are needed to check for side effects.
- Cost and access vary. Coverage depends on country and insurance.
Side Effects to Know About
The main safety concern with anti-amyloid drugs is called ARIA, short for amyloid-related imaging abnormalities. It can involve swelling in the brain (ARIA-E) or small bleeds (ARIA-H). Most cases cause no symptoms and are detected on MRI scans, but some people experience headaches, confusion, dizziness, or vision changes, and rarely serious complications.
The risk of ARIA is higher in people who carry two copies of the APOE e4 gene, which is why genetic testing is often recommended before treatment. Doctors have also developed gentler dosing schedules that appear to reduce the risk of ARIA. People taking blood-thinning medications need particularly careful assessment.
Easier Diagnosis Is Opening Doors
Because these treatments work best early, diagnosis matters more than ever. A major advance has been FDA-cleared blood tests that detect Alzheimer's-related proteins. Since 2025, several have become available, making it easier for doctors to identify Alzheimer's in people with symptoms without always needing expensive PET scans or spinal taps.
Earlier diagnosis also gives people more time to make informed choices. Someone who learns early that Alzheimer's is the cause of their symptoms can discuss treatment options with their doctor, consider joining a clinical trial, and plan ahead while they can fully take part in decisions about their future.
Treating Other Symptoms
Alzheimer's affects more than memory. Treatments are available for related symptoms such as:
- Sleep problems
- Depression and anxiety
- Agitation, for which a medication called brexpiprazole was approved in the US in 2023
Non-drug approaches, such as structured routines, music, exercise, and environmental changes, are often tried first and can be very effective.
What's Next in Research
The Alzheimer's research pipeline is the largest in the field's history, with well over a hundred potential treatments being tested in clinical trials. Promising directions include:
- Preventing Alzheimer's before symptoms: trials are testing anti-amyloid drugs in people who have amyloid in the brain but no symptoms yet.
- Targeting tau: treatments aimed at tau tangles, the other hallmark of Alzheimer's.
- Reducing inflammation: drugs that calm harmful inflammation in the brain.
- Metabolic approaches: including medications originally developed for diabetes and weight loss.
- Protecting brain cells and connections: therapies aimed at keeping neurons healthy.
- Combination therapies: using several approaches together, much as cancer and heart disease are treated.
Lifestyle Still Matters
Alongside medical treatment, healthy habits support brain health and quality of life for people with Alzheimer's and those at risk:
- Regular physical activity
- Social connection
- Mentally stimulating activities such as reading, music, puzzles, and brain games
- A balanced diet
- Good sleep
- Managing blood pressure, blood sugar, and cholesterol
- Treating hearing loss
Considering a Clinical Trial
Clinical trials are how new treatments are developed, and many need volunteers, including people with early symptoms and healthy people at risk. Ask a doctor or memory clinic about trials in your area.
Frequently Asked Questions
Is there a cure for Alzheimer's?
Not yet. But new treatments can slow the disease in its early stages, and research is moving quickly.
What are the newest Alzheimer's drugs?
Lecanemab (Leqembi) and donanemab (Kisunla) are anti-amyloid treatments that can slow early Alzheimer's.
Who can get the new Alzheimer's drugs?
People with mild cognitive impairment or mild dementia due to Alzheimer's, with confirmed amyloid in the brain.
Are the new drugs safe?
They carry a risk of side effects, mainly ARIA, which requires MRI monitoring. Doctors weigh benefits and risks for each person.
Key Takeaways
- Older medicines can ease symptoms for a time.
- Lecanemab and donanemab are the first treatments to slow early Alzheimer's.
- They work best early and require monitoring for side effects.
- New blood tests are making early diagnosis easier.
- The research pipeline is larger than ever, bringing real hope.
Alzheimer's treatment has entered a new era. While there's still no cure, there's more reason for hope today than ever before. If you have concerns about memory, an early conversation with a doctor could open the door to the best available options.
This article provides general educational information and is not medical advice. A qualified healthcare professional can help you evaluate choices in relation to your health history, medications, and individual needs.