Available treatments for familial Alzheimer’s disease
Last Reviewed: Jul 2, 2025When people learn they’re a part of the familial Alzheimer’s community, one of their first questions is often, “What are our treatment options?”
Until recently, treatment options were limited. But decades of research are paying off.
Now, there are treatment options available to not only manage symptoms, but more importantly, to potentially slow down the disease. The U.S. Food and Drug Administration (FDA) has approved certain medications for Alzheimer's disease. These include three main classes of drugs.
Amyloid-targeting antibodies
Includes Leqembi (Lecanemab) ⧉ and Kisunla (Donanemab) ⧉
How they work: Targeting and removing Aβ (the main component of amyloid plaques) from the brain by administering, through an IV, monoclonal antibodies that are directed against different forms of the protein.
Benefit: This class of drugs targets amyloid, and evidence suggests that it can remove amyloid plaques and slow the progression of Alzheimer's disease if given early enough. ¹
Safety: The most common side effects are infusion site reactions, headache, vision changes, confusion, balance problems, and other stroke-like symptoms. These drugs can also cause amyloid-related imaging abnormalities (ARIA), which involves temporary swelling or bleeding in the brain. ARIA may be life-threatening or fatal in rare cases.
Approval Status: Both Leqembi and Kisunla have been approved for people with mild cognitive impairment or mild dementia due to Alzheimer’s disease. Researchers continue to study the drugs’ long-term safety and efficacy.
Limits: This class of drugs is not a cure and does not improve memory or thinking, but it has been found to slow disease progression in people with early-stage Alzheimer’s.
Cholinesterase inhibitors
Includes Aricept (Donepezil) ⧉, Exelon (Rivastigmine) ⧉, and Razadyne (Galantamine) ⧉
How they work: Block the breakdown of a brain chemical called acetylcholine, which is critical for communication between brain cells (also known as synaptic activity).
Benefit: These drugs have modest cognitive benefits but their effectiveness can vary from person to person.
Safety: They are considered safe. Some people experience reversible side effects such as diarrhea, nausea, and/or vomiting.
Approved for:
Aricept and Exelon have been approved for mild, moderate, and severe Alzheimer’s disease.
Razadyne has been approved for mild and moderate Alzheimer’s disease.
Limits: Overall, this class of drugs can reduce symptoms, but they do not halt or prevent the progression of the disease.
NMDA receptor antagonists
Includes Namenda (Memantine) ⧉
How they work: NMDA receptors affect the way brain cells communicate with each other. In Alzheimer's disease it is thought that these receptors become overexcited (over-activated) leading to excitotoxicity in the brain. Memantine works to block the overactivation of this receptor. However, it does not interfere with normal synaptic activity.
Benefit: These drugs have small positive effects on cognition, mood and behavior.
Safety: They are normally well-tolerated. Some people who take these drugs experience confusion, dizziness, drowsiness, headache, insomnia, agitation, and/or hallucinations.
Approved for: Namenda is approved for moderate and severe Alzheimer's disease and is often used in combination with other drugs.
Limits: Like cholinesterase inhibitors, this class of drugs can reduce symptoms, but it doesn’t halt or prevent the progression of Alzheimer’s disease.
Other available treatments
Other medications: For depression, aggression, sleep disturbance, seizures and hallucinations, physicians can help people with FAD manage symptoms on an individual basis. Communication and cooperation between neurologists and psychiatrists will help ensure proper prescription usage.
Physical and occupational therapy: Physical and occupational therapy can help manage symptoms related to problems with walking or activities of daily living.
Other therapeutic activities: Other non-drug treatments include physical activity, memory and orientation exercises, and music- and art-based therapies.
Sources
The SOURCE/Medicine & Health. Anti-amyloid drug shows signs of preventing Alzheimer’s dementia. Hope Center for Neurological Disorders, Washington University in St. Louis. 2025 Mar 21 [cited 2025 May 20]. Link