Aducanumab alternatives: what to consider now

Aducanumab (Aduhelm) made headlines, but it isn’t the only path for people with early Alzheimer’s. If you or someone you care for is weighing options, you’ll want straight facts: what works now, what’s coming, and what you can do at home to slow decline or improve quality of life.

Approved drugs and similar antibody treatments

There are two types of medical approaches right now. One treats symptoms, the other aims at amyloid protein in the brain.

For symptoms: donepezil, rivastigmine, and galantamine (cholinesterase inhibitors) can help memory and daily function for months to years in some people. Memantine works on different brain signals and is often used for moderate to severe cases. These drugs won’t cure Alzheimer’s, but they’re widely available, covered by many plans, and regularly prescribed.

For disease-modifying antibodies: lecanemab (Leqembi) received FDA approval and targets amyloid like aducanumab. Donanemab is another antibody that showed promising results in trials but may still need more regulatory steps in some countries. These treatments reduce amyloid but require brain scans or lumbar puncture to confirm amyloid, and regular MRI monitoring because of ARIA — a side effect that can cause swelling or small bleeds in the brain.

Other options: trials, lifestyle, and supportive care

Clinical trials remain one of the best ways to access new drugs. Trials test tau-targeting therapies, vaccines, small molecules, and combinations. Ask a neurologist or memory clinic about nearby trials — centers often screen patients and explain eligibility and risks.

Lifestyle changes matter. Regular aerobic exercise, good sleep, blood pressure and cholesterol control, and a Mediterranean-style diet all support brain health. Cognitive training and social engagement can help with daily function. These steps are not magic fixes, but they’re low-risk and often helpful alongside medicines.

Supportive care is practical and immediate. Occupational therapy, home safety adjustments, caregiver training, and legal/financial planning make daily life better and reduce stress for families. Small changes — consistent routines, visual cues, simplified tasks — often yield big benefits.

How to choose? Start with an honest, specific talk with a dementia specialist. Ask: “Is my loved one amyloid-positive?” “What side effects should I expect?” “How will this change daily life?” If considering an antibody treatment, confirm required tests, MRI schedule, costs, and who will manage side effects.

If cost or access is an issue, discuss alternatives like symptom drugs, rehab services, or joining a trial. Avoid buying unregulated products online. If you need help finding clinics or trials, many national Alzheimer’s organizations offer searchable directories and phone support.

Alzheimer’s care is rarely one-size-fits-all. Combine medical options with practical supports, and keep close communication with your care team. Small, steady decisions often make the biggest difference over time.