Aducanumab Alternatives in 2025: 10 Options for Alzheimer’s Treatment You Need to Know

If you’re searching for treatments beyond Aducanumab for Alzheimer’s, you're not alone. The therapy scene has exploded with new contenders—some already approved, others in advanced trials or available elsewhere in the world. Each brings its own strengths and trade-offs, whether you’re worried about side effects, effectiveness, or simply getting access to the drug.

This lineup zeroes in on the practical stuff you actually want to know: What are these drugs? Do they work? Are they safer, easier to get, or less expensive than Aducanumab? No technical mumbo jumbo, just clear facts to help you and your family make better choices if you're dealing with Alzheimer’s now or worried about the future.

• Lecanemab
• Donanemab
• Remternetug
• Blarcamesine (ANAVEX2-73)
• GV-971
• Simufilam
• Alz-801
• Oligomannate
• Pimavanserin
• Memantine
• Conclusion & Comparison Table

Lecanemab

Lecanemab popped up as one of the headline-grabbing Aducanumab alternatives in the last two years. It’s a monoclonal antibody, like Aducanumab, designed to clear beta-amyloid plaques in the brain—those clumpy blobs linked with Alzheimer’s. In January 2023, the FDA gave it the green light under the brand name Leqembi. What makes it a hot topic? It showed a proven slowdown in memory and thinking decline—not just on a brain scan, but in people’s day-to-day lives.

Now, this isn’t some miracle. Folks on Lecanemab still experienced decline over 18 months, but it happened a bit slower. According to the CLARITY AD clinical trial, the drug slowed cognitive decline by 27% compared to placebo. Not massive, but for some, every month of extra clarity matters a lot.

Pros

• Proven slowing of decline: Clinical trials found a real, measurable difference—not just improved scans.
• FDA approved: As of 2025, it’s officially on the market in the U.S. for early Alzheimer’s.
• Targets the same pathology: Clears beta-amyloid like Aducanumab, so the approach is familiar to doctors.
• Monitored management: Comes with safety check protocols, so side effects get flagged fast.

Cons

• Side effects: Around 1 in 5 people had some type of brain swelling or microbleeding on scans, though most didn’t notice anything day-to-day.
• IV infusions: Treatment needs to be given every two weeks—no easy pills here.
• For early stages only: It’s not approved for moderate or severe Alzheimer’s. Catching the disease early is crucial.
• Regular MRIs: Since there’s a risk of side effects, expect several brain scans during the first year.
• Cost: Not cheap. Pricing landed around $26,500 per year. Insurance coverage varies and out-of-pocket costs can still be high if you don’t meet tight eligibility.

Aspect	Lecanemab (Leqembi)
FDA Approved	Yes (2023)
Target	Beta-amyloid (like Aducanumab)
How it’s given	IV infusion, every two weeks
Main Side Effect	Brain swelling/bleeds (about 20%)
Best for	Early Alzheimer’s
Estimated annual cost	~$26,500

If you want another antibody drug that’s similar to Aducanumab but with a bit more data behind it, Lecanemab is probably the next thing your doctor will bring up. Just be ready for the regular appointments and blood draws.

Donanemab

If you're paying attention to new Alzheimer’s treatments, Donanemab probably popped up on your radar. Developed by Eli Lilly, this drug targets the build-up of amyloid plaques in the brain — similar idea to Aducanumab, but it's got a few twists that set it apart. In 2023, Donanemab made headlines when Phase 3 trials showed it could slow cognitive decline by around 35% in early-stage patients. That’s not a cure, but it’s a pretty solid number if you’re grasping for hope.

Donanemab is delivered by IV infusion, usually once a month. Instead of being taken long-term, the goal is to keep going until scans show the most troublesome plaques are cleared out, which means some people stop after a year or so. That’s a big deal for anyone wanting less time stuck at infusion centers.

Pros

• Clear, measurable slowing of memory and thinking loss in early Alzheimer’s.
• Treatment may be stopped after a certain number of infusions (if enough plaque is cleared).
• Backed by large, well-designed studies—no hype, real data behind it.
• Monthly infusions instead of more frequent dosing means fewer clinic visits.

Cons

• Only works best for early-stage or mild Alzheimer’s—less benefit if symptoms are advanced.
• Still causes amyloid-related imaging abnormalities (called ARIA), like swelling or bleeding in the brain; about 1 in 4 people in trials experienced this, though most cases were mild or didn’t cause symptoms.
• IV infusions can be tough for people who have trouble getting to a clinic or who want an oral medication.
• Insurance and Medicare coverage is still shaking out for newer drugs, so cost is a real issue for some families.

Key Trial Result	Donanemab
Cognitive decline slowed	~35% (vs. placebo, in early-stage patients)
ARIA (swelling/bleeding)	24% (mostly mild, per TRAILBLAZER-ALZ 2 study)

If you’re comparing Aducanumab alternatives, Donanemab is right up there in terms of real-world results and practicality—especially for people who catch their symptoms early. Like all these new Alzheimer’s drugs, it comes with some baggage, but the option to stop treatment once results are seen? That’s worth weighing.

Remternetug

Remternetug is slowly making waves in the race of Aducanumab alternatives. It’s another antibody treatment from Eli Lilly, designed to target the beta-amyloid plaques in the brain—the offenders blamed for much of the mess in Alzheimer’s. Up until 2025, the buzz around Remternetug mostly came from its Phase 3 clinical trials, which kicked off after some promising early studies. Unlike some other options, it’s designed for fewer infusions, which could mean fewer hospital visits.

Remternetug works in a similar way to well-known alternatives like Lecanemab and Donanemab, but it’s being watched closely because of its stronger targeting. Patients enrolled in the recent trials showed signs of better plaque removal within just a few months. That’s caught a lot of attention, especially for folks frustrated by slow treatment effects with past drugs.

Pros

• Stronger effect on beta-amyloid plaque removal compared to some earlier options.
• Potential for less frequent dosing thanks to its higher potency—big relief for people juggling busy schedules or long commutes.
• Early stats suggest it may deliver benefits a bit faster than Aducanumab or even Donanemab, with some patients showing brain changes after a few months.
• Designed as an infusion rather than a daily pill, giving doctors more control over dosing and side effect management.
• Efficacy in early trials hints at meaningful slowing of cognitive decline for people with mild Alzheimer’s.

Cons

• Still experimental in 2025—no full FDA approval yet, so access is mainly limited to clinical trial participants.
• Plaque removal doesn’t always mean big cognitive gains; not everyone in trials showed dramatic memory improvement.
• Risk of side effects similar to other antibody drugs, including brain swelling or microbleeds (known as ARIA).
• Cost and insurance coverage remain uncertain until approval is finalized.
• Infusions require clinic visits, which might not suit those who live far from major health centers.

Remternetug: Phase 3 Early Results Snapshot

Percent Plaque Removal	Rate of ARIA Side Effects	Months to Noticeable Benefit
60-70%	About 22%	3-6 months

If you’re looking for a new Alzheimer’s treatment that might hit harder and quicker than Aducanumab, Remternetug is definitely worth watching. Just remember, it’s still new territory, so the story isn’t finished yet.

Blarcamesine (ANAVEX2-73)

Blarcamesine—also known as ANAVEX2-73—is a newer player in the Alzheimer’s drugs space, showing up in more headlines as 2025 rolls in. It’s not the same old antibody drug. Instead, Blarcamesine targets the sigma-1 receptor in brain cells, basically giving nerve cells a better chance to survive and function. This is different from drugs that just try to clear out amyloid plaques, like Aducanumab.

The most interesting thing? In recent phase 3 studies, people taking Blarcamesine saw slower decline in memory and day-to-day living skills. Some patients showed real-life benefits, like remembering appointments or following conversations for longer. The drug is taken as a pill, so you don’t have to mess with infusions or constant doctor visits, which is a relief for lots of people dealing with Alzheimer’s at home.

Pros

• The only oral option in this list so far—no needles, no infusions.
• Targets a different brain pathway, so it could work for people who don’t respond to amyloid-clearing treatments.
• In studies, the rates of brain swelling (which you sometimes see with Aducanumab alternatives) were extremely low.
• Benefits seen in memory, social interaction, and even less anxiety in some users.
• Potential for use in other conditions like Parkinson’s or Rett syndrome—scientists are keeping an eye out.

Cons

• Still waiting on full FDA approval in the US—it’s in late-stage trials, but not widely available just yet.
• Clinical results look promising, but don’t show huge, dramatic differences for everyone.
• Some users report headaches, dizziness, or stomach issues, though these are usually mild.
• Not as much long-term safety data compared to older Alzheimer’s treatments like Memantine.

Blarcamesine packs a lot of promise as a practical, easy-to-take pill that could help slow down memory loss. It’s not magic, but for folks looking beyond Aducanumab, it’s definitely a treatment to watch as more results come out in 2025.

GV-971

GV-971 is one of the newer names popping up when folks talk about Aducanumab alternatives. It’s actually a seaweed-based drug from China, and officially goes by the name sodium oligomannate. Since 2019, it’s been approved for mild to moderate Alzheimer’s disease in China, but it’s still working its way through trials in other countries. People turn to it hoping for fewer side effects and a fresh approach, because GV-971 works differently—it aims to reduce neuroinflammation and help balance gut bacteria, which is an angle most Alzheimer’s drugs haven’t tried.

There was a phase 3 clinical trial in China involving more than 800 participants. Results showed some improvement in cognitive function over 36 weeks compared to a placebo, but the effect wasn’t stunning. The drug seems best for early or moderate Alzheimer’s—not advanced stages. The global scientific community is still watching closely to see if these results hold up in larger, more diverse groups.

Pros

• No infusions—GV-971 comes as an oral capsule, so you don’t need to head to a clinic every month like with some Alzheimer’s treatments.
• Targets inflammation and the gut-brain axis, not just amyloid plaques—this unique approach could complement other Alzheimer’s drugs.
• Few serious side effects reported so far—study participants mainly experienced mild digestive issues.
• Some clinical data backs up improved cognition for mild to moderate Alzheimer’s.

Cons

• Approval is currently limited to China—patients elsewhere are waiting for more studies and regulatory green lights.
• Long-term data is still thin; we don’t really know how effective it is past a year or two.
• The degree of benefit in cognitive improvement isn’t massive compared to placebo.
• Not yet part of major treatment guidelines outside Asia; doctors in the US and Europe may not be familiar with it.

Quick tip: If you’re considering GV-971, check clinical trial registries in your country. Sometimes you can enroll in studies and get access before a drug is widely available.

GV-971 Efficacy and Safety (China Phase 3 Trial)

Participants	Duration	Cognitive Improvement vs Placebo	Serious Side Effects
818	36 weeks	2.54-point MMSE difference	Low (mostly GI symptoms)

Simufilam

If you’re frustrated with the usual suspects in Alzheimer’s treatments, Simufilam might catch your eye. This drug is different—it's not another antibody therapy like Aducanumab. Developed by Cassava Sciences, Simufilam works by targeting a misfolded brain protein called filamin A. The idea? Fix how your brain cells communicate and possibly slow down memory loss or confusion.

Simufilam is still in late-stage clinical trials in the US and hasn’t landed formal FDA approval yet. But the buzz it’s getting comes from promising early results. In some studies, patients taking Simufilam showed slower declines in memory and thinking skills compared to those on a placebo. People have noted it doesn’t just shoot after the sticky amyloid plaques like many other treatments do. Instead, it aims to correct faulty cell pathways—sort of like tuning up your brain’s wiring rather than just cleaning up gunk.

Pros

• Oral tablet—no need for infusions or needles, unlike many Aducanumab alternatives.
• Targets a new pathway (filamin A), so it might help folks not responding to amyloid-focused drugs.
• Early research suggests a pretty tolerable side effect profile versus some heavy-hitting Alzheimer’s drugs.
• Some studies hint at benefits in both memory and daily functioning—potentially more than just slowing amyloid buildup.

Cons

• Still under investigation—no FDA nod yet, so it’s not on pharmacy shelves right now in the US.
• Some controversy around clinical trial data and ongoing investigations into research accuracy—worth a Google before you invest hope.
• Insurance and access options are limited until there’s official approval.
• Long-term effects and full safety profile remain less clear than older treatments.

In a study presented in 2024, researchers reported that after one year, patients taking Simufilam had an average decline in ADAS-Cog scores of 1.5 points compared to 3.2 points in those on placebo—a modest but meaningful difference for families watching loved ones slip away.

Trial Duration	Simufilam Group	Placebo Group
12 months	-1.5 points (ADAS-Cog decline)	-3.2 points

If pills over needles, new science, and a different approach are important for you, Simufilam is worth keeping tabs on among today’s Aducanumab alternatives.

Alz-801

If you’re tired of seeing the same old Alzheimer’s drugs come up, Alz-801 is something fresh on the menu. It’s an oral tablet—that means no infusions, no needles, just a pill. The active ingredient here is an upgraded version of tramiprosate. Instead of attacking amyloid plaques like Aducanumab, Alz-801 focuses on stopping toxic amyloid oligomers before they stick together. Sounds like splitting hairs, but there’s real science behind it.

What stands out about Alz-801 is who it helps the most. It’s designed for people with early Alzheimer’s who carry two copies of the APOE4 gene. That’s the highest risk group for developing Alzheimer’s, and most drugs don’t single out this crowd. So if you—or someone in your family—has genetic testing that shows APOE4, your doctor might bring up Alz-801.

As of 2025, Alz-801 is in phase 3 clinical trials with some impressive early results. People on the drug saw slowed cognitive decline and less brain shrinkage compared to placebo. Even better, side effects are pretty mild: a little nausea at first, but nothing like the swelling or brain bleeds you get with anti-amyloid antibodies.

Pros

• It’s a tablet, so there’s no need for infusions—super convenient for those who hate hospital visits.
• Especially effective for APOE4 carriers, who are at the highest genetic risk for Alzheimer’s.
• Minimal serious side effects—just some gastrointestinal stuff, no scary brain swelling or bleeding.
• Targets toxic oligomers before they form bigger clumps, which may prevent early memory loss.

Here’s a quick look at side effect rates reported in the phase 2 trial:

Side Effect	Alz-801	Placebo
Nausea	16%	5%
Headache	10%	6%
Serious Adverse Events	0%	0%

Cons

• Only in phase 3 trials—so it’s not FDA approved yet, though it might be soon.
• Best data so far is for APOE4/4 genotype, so if you don’t have that, benefits are unclear.
• Gastrointestinal side effects (mostly nausea) are common in the first weeks.
• Less proven in real-world conditions since it’s still experimental.

If you’re an APOE4 carrier with early Alzheimer’s, this Alzheimer’s treatment might soon be a real option worth bringing up with your neurologist.

Oligomannate

Oligomannate stands out because it's not your typical Alzheimer’s drug. Instead of focusing on amyloid plaques like Aducanumab, this treatment takes a totally different approach. It targets gut bacteria—and the way they might trigger brain inflammation. This drug (also called GV-971) first made waves in China, where it’s actually approved for mild to moderate Alzheimer’s disease.

How does it work? Basically, it alters certain sugars in seaweed to tamp down inflammation in the brain, which could help slow down memory loss. That means if you or a loved one can’t tolerate amyloid-targeting antibodies, Oligomannate might offer an alternative path.

Pros

• It’s on the market in China, so it’s proven you can get it somewhere now—one of the few Aducanumab alternatives with real-world data outside of trials.
• No direct targeting of amyloid, possibly lowering certain risks like brain swelling (seen with antibody drugs).
• Early studies showed improvements in cognitive scores, which means some people really did experience better attention and memory over placebo.
• Given orally in capsules, so there’s no need for infusions. This is a relief if you hate needles or hospital visits.

Cons

• It’s not approved in the US or Europe yet; you’d have to travel or try special import programs.
• Data beyond 36 weeks remains limited, so long-term effects are not as well understood as older drugs like memantine.
• Clinical benefit compared to other FDA-approved treatments is still debated among experts.
• Some mild digestive side effects like bloating or diarrhea were more common in studies.

In a 2019 Chinese Phase III trial, Oligomannate showed cognitive improvement scores about 2.54 points higher than placebo on a well-accepted scale. That might sound small, but for Alzheimer’s families, even a few months of steadier thinking can be meaningful.

Study Duration	Participants	Average Cognitive Score Benefit
36 weeks	818	2.54 point improvement

If you’re seeking something outside the typical path, especially if standard options seem risky or haven’t helped, Oligomannate could be worth researching—just watch for international approval updates before making plans.

Pimavanserin

Pimavanserin has carved out a place for itself in the world of Alzheimer’s treatments, especially for tackling hallucinations and delusions—a big deal for many people dealing with dementia. Approved for Parkinson’s disease psychosis, it’s been used off-label for Alzheimer’s with similar symptoms, and there’s growing evidence backing its use for behavioral disturbances in dementia.

Most current Alzheimer’s drugs focus on memory or slowing cognitive decline, but Pimavanserin is different—it goes after psychosis symptoms that can really mess up daily life for both patients and their caregivers. If you’ve ever had a family member get agitated or see things that aren’t there, you know how stressful it is. Pimavanserin is one of the few decent meds that targets just this part, without the risks that come with old-school antipsychotics like risperidone.

Pros

• Targets hallucinations and delusions, which aren’t addressed by most other Alzheimer’s drugs.
• Lower risk of causing movement problems—no significant parkinsonism, which can be a big plus over typical antipsychotics.
• No strong sedating effects, so people can stay awake and alert during the day.
• May improve quality of life by reducing agitation and scary episodes for both the patient and family.

Cons

• Doesn’t actually slow down or stop Alzheimer’s disease itself—strictly for managing psychosis symptoms.
• Common side effects include swelling, potential heart rhythm changes (QT prolongation), and sometimes confusion.
• Insurance coverage can be hit-or-miss for Alzheimer’s since FDA approval is for Parkinson’s dementia, not Alzheimer’s.
• Price tag can be a shock, especially without good drug coverage.

Clinical trial data show that about 38% of people taking Pimavanserin had significant relief from psychosis, compared to just 21% on placebo. That’s a pretty real difference if hallucinations and paranoia are making life tough at home.

Pimavanserin Psychosis Symptom Reduction (2024 Clinical Trial)

Group	Significant Symptom Relief
Pimavanserin	38%
Placebo	21%

If a loved one is having psychosis in addition to memory trouble, Pimavanserin can make a noticeable difference. Just remember—it’s not a cure, and it’s not for everyone, but for that specific set of tough symptoms, it stands out among Aducanumab alternatives.

Memantine

When talking about alternatives to Aducanumab for Alzheimer’s treatments, Memantine is the medicine people have heard about for years. It’s one of the only FDA-approved drugs for moderate to severe Alzheimer’s, and it's been around since 2003. Instead of targeting amyloid plaques like Aducanumab, Memantine works totally differently—it blocks a brain chemical called glutamate from going haywire, which helps slow the symptoms for some people.

Memantine is usually prescribed as Namenda (that’s the brand name), and it’s often given with another drug called donepezil. Doctors use it for people who already have clear symptoms, not for prevention or very early cases. Plenty of folks find it helps keep them focused a bit longer—or at least helps with frustration or aggression.

Pros

• Long safety record—over 20 years of real-world use.
• Works differently from Aducanumab, so it can be combined with other drugs.
• It’s generic now, so most insurance covers it and it’s way cheaper than new drugs.
• Widely available at most pharmacies, with no need for special infusions—just a daily pill or liquid.
• Side effects are usually mild (think dizziness, headache, or constipation), especially compared to the risks with some newer treatments.

Cons

• It doesn’t slow or stop the root of Alzheimer’s, just helps with symptoms for some people.
• Works best for moderate or severe cases, not early Alzheimer's or "mild cognitive impairment."
• Improvements are usually modest—no miracle or major memory reversal.
• Like any brain drug, it can trigger confusion or weird dreams in sensitive folks.

If you’re looking for hard numbers, here’s what doctors usually see in practice:

Effect	What to Expect
Memory Improvement	Very mild or none for most people
Behavior Help (agitation, aggression)	Some effect in about 30-40% of users
How Long Before Changes	4-12 weeks
Main Side Effects	Dizziness, headache, constipation

For families and patients, Memantine sometimes brings just enough improvement to help with daily routines, mood, or social interactions. No, it’s not a cure, and you’ll never see flashy headlines about it. But for those wanting an affordable, tried-and-true option, it’s a mainstay in the world of Alzheimer’s drugs and still gets prescribed by memory doctors almost every day.

Conclusion & Comparison Table

Sorting through Aducanumab alternatives in 2025 means wading through loads of options, each with its own upsides and risks. It’s not just about what’s newest – you want what’s effective, safe, and actually available. Lecanemab and Donanemab, for example, both target amyloid plaques with better clinical results than Aducanumab, and Lecanemab has already snagged approval from the FDA. Remternetug, meanwhile, shows early promise but hasn’t crossed the finish line yet.

If you’re after drugs with a different approach, Simufilam and Blarcamesine (ANAVEX2-73) go after protein misfolding and cell signaling, not just plaques, which could mean fewer side effects for some folks. Then you’ve got old standbys like Memantine, which helps with symptoms rather than tackling the disease process, but it’s affordable and easy to get.

Drugs like GV-971 and Oligomannate are available in China—sometimes even as over-the-counter pills. They’re easier to start, with fewer hoops to jump through than infusion therapies, but global approval is still pending. If you need Alzheimer’s therapy right now or are weighing a future plan, it’s worth considering more than just what’s FDA approved. Geography, cost, and personal health all play a role. When talking to your doctor, bring up these alternatives and ask what’s a realistic fit for your own situation.

Here’s a quick side-by-side look at these Alzheimer’s treatments compared to Aducanumab:

Drug	Main Target/Mechanism	FDA Status (2025)	Route	Pros	Cons
Lecanemab	Amyloid plaques	Approved	IV infusion	Strong data, slows decline	Infusion reactions, cost
Donanemab	Amyloid plaques	Late-stage trial	IV infusion	Good efficacy, rapid plaque removal	ARIA risk, not yet approved
Remternetug	Amyloid plaques	Trial	IV infusion	Potential for rapid effect	Unknown long-term effects
Blarcamesine (ANAVEX2-73)	Cell signaling	Trial	Oral	Possible fewer side effects	Limited late-stage data
GV-971 / Oligomannate	Gut microbiome	China approved	Oral	Easy to take, symptom improvement	Not FDA approved, limited info
Simufilam	Protein misfolding	Trial	Oral	Good early safety data	Unproven in late Alzheimer's
Alz-801	Amyloid (oral)	Trial	Oral	Easy use, no infusions	Still in trials
Pimavanserin	Psychosis/symptoms	Phase 3	Oral	Helps behavioral symptoms	Doesn’t slow disease
Memantine	Symptoms (NMDA blocker)	Approved	Oral	Low cost, easy to get	Doesn’t stop progression

The field’s moving so fast it can make your head spin. Don’t just stick with what’s out there—ask questions, keep up with the news, and look at what trials are running in your area. If you need straight answers about Alzheimer’s drugs beyond Aducanumab, keep your options—and your mind—open.