Yes, there are several FDA-approved medicines for Alzheimer’s disease. They fall into two broad categories: drugs that manage symptoms like memory loss and confusion, and newer drugs that target the underlying disease process in the brain. None of them cure Alzheimer’s, but they can slow cognitive decline and, in some cases, extend the period a person can live independently.
Medicines That Manage Symptoms
The longest-established Alzheimer’s drugs are cholinesterase inhibitors, which work by boosting levels of a brain chemical involved in memory and learning. Three are currently prescribed: donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). All three are daily medications, either as pills or, in the case of rivastigmine, a skin patch. Donepezil is the most broadly approved of the group, covering mild through severe stages of the disease. Galantamine and rivastigmine are approved for mild to moderate stages.
The most common side effects across all three are nausea, vomiting, diarrhea, and loss of appetite. These gastrointestinal symptoms show up in roughly 20 to 30 percent of people taking donepezil, and are more common with oral rivastigmine and galantamine. Switching to the rivastigmine patch significantly reduces stomach-related side effects.
For moderate to severe Alzheimer’s, there is also memantine (Namenda), which works differently. Instead of boosting a helpful brain chemical, it blocks excessive activity of a receptor involved in nerve cell damage. Memantine is not approved for mild Alzheimer’s, so cholinesterase inhibitors are the main option in early stages. In later stages, doctors sometimes prescribe memantine alongside donepezil. The FDA has approved a fixed-dose combination pill called Namzaric for this purpose. A large network analysis found that the donepezil-plus-memantine combination was more effective than either drug alone at improving cognition, daily functioning, and behavioral symptoms like agitation and anxiety in people with moderate to severe disease.
It’s important to understand what these symptom-managing drugs can and cannot do. They don’t change the course of the disease. They may stabilize or modestly improve thinking and daily function for a period of months, but Alzheimer’s continues to progress in the background.
Newer Drugs That Target the Disease
A newer class of Alzheimer’s medicines works by clearing amyloid plaques, the sticky protein clumps that build up in the brains of people with the disease. Two are currently FDA-approved: lecanemab (Leqembi) and donanemab (Kisunla). Both are given by intravenous infusion, not as pills.
These drugs don’t just manage symptoms. They slow the rate of cognitive decline by removing amyloid from the brain. In clinical trials, lecanemab reduced the pace of decline over 18 months compared to a placebo, as measured on a standard dementia rating scale. Both drugs are approved only for people in the early stages of the disease, specifically those with mild cognitive impairment or mild dementia who have confirmed amyloid buildup in the brain.
A previous amyloid-clearing drug, aducanumab (Aduhelm), received accelerated FDA approval in 2021 but was discontinued by its manufacturer, Biogen, in 2024. It is no longer available.
What These Drugs Mean in Practical Terms
When clinical trials report results like “27 percent reduction in cognitive decline,” it can be hard to know what that means for everyday life. Researchers at Washington University School of Medicine translated those numbers into something more concrete: months of independent living.
A typical patient who started treatment with very mild symptoms could expect to live independently for about 29 months without any treatment. With lecanemab, that extended to roughly 39 months. With donanemab, about 37 months. That’s an additional 8 to 10 months of being able to manage daily life on your own.
For people with mild symptoms (one step further along than “very mild”), most were already unable to live fully independently. The more relevant question at that stage was how long they could still handle personal care like bathing, dressing, and hygiene. With lecanemab, that self-care window extended by about 26 months. With donanemab, about 19 months. These are meaningful gains, but they don’t stop the disease. At best, these drugs slow the decline.
Side Effects of Amyloid-Clearing Drugs
Lecanemab and donanemab carry a specific risk that symptom-managing drugs do not: brain swelling or small brain bleeds, collectively known as amyloid-related imaging abnormalities, or ARIA. ARIA-E refers to fluid accumulation causing swelling. ARIA-H refers to tiny bleeds or blood product deposits in brain tissue. Most cases are mild and produce no noticeable symptoms, but some people experience headaches, confusion, dizziness, or visual changes.
Because of this risk, treatment requires regular brain MRI scans to catch any changes early. An MRI is typically obtained within three to four months of starting treatment, with additional scans at set intervals. If mild ARIA appears without symptoms, treatment may continue with closer monitoring. If moderate ARIA develops, the infusions are paused until the swelling or bleeding resolves. Before starting donanemab, genetic testing is also performed, because people who carry a specific gene variant (ApoE ε4) face a higher risk of developing these brain changes.
How Treatment Is Given
The older symptom-managing drugs are straightforward to take. Donepezil is a once-daily pill. Galantamine comes as a pill or extended-release capsule. Rivastigmine is available as a capsule, liquid, or skin patch. Memantine is an oral tablet. These are all taken at home.
The newer amyloid-clearing drugs are different. Both lecanemab and donanemab require intravenous infusions at a medical facility, typically every two to four weeks. This means regular clinic visits over an extended treatment period, along with periodic MRI monitoring. The time commitment is substantial, and it’s a practical factor worth weighing alongside the potential benefits, especially since these drugs are only effective in early-stage disease. Starting treatment sooner, when symptoms are very mild, appears to yield the greatest benefit in terms of additional months of independence.