Alzheimer’s Drugs in 2025: Have We Turned the Corner?

Alzheimer’s disease is one of the most complex and challenging conditions in medicine. Pharmaceutical treatment has largely focused on managing symptoms of the disease. But we may have reached a turning point. For the first time, there has been a meaningful shift from symptom management to using new medications for disease modification.

Here’s a look at what medications are available now—and what’s coming soon.

1. Disease-Modifying Antibodies: Leqembi and Kisunla

The biggest breakthroughs in recent years are two monoclonal antibodies: Leqembi (lecanemab) and Kisunla (donanemab). Both are FDA-approved and target beta-amyloid, a protein that builds up in the brains of people with Alzheimer’s. 

Leqembi was the first to show it could slow cognitive decline by clearing toxic amyloid protofibrils. Kisunla has proven more cost-effective and generally less burdensome for patients by providing a monthly infusion schedule and the potential to stop treatment once amyloid is cleared. 

However, these drugs are only approved for people in the early stages of Alzheimer’s and require amyloid confirmation via PET scan or blood test. They also carry risks, including ARIA (brain swelling or microbleeds), especially in people with the ApoE4 gene.

Most patients still rely on cholinesterase inhibitors like donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne). These drugs don’t slow disease progression but can improve memory and attention for 6–12 months.

A newer option, Adlarity, is a once-weekly patch that delivers donepezil through the skin—ideal for patients who struggle with pills.

For agitation, the FDA approved Rexulti (brexpiprazole) in 2023. It’s the first drug specifically approved for Alzheimer’s-related aggression, though it comes with increased mortality risks.

The Alzheimer’s drug pipeline is more diverse than ever. In 2025, 138 drugs are being tested in nearly 200 clinical trials, targeting everything from amyloid and tau to inflammation and synaptic function.

1. Repurposed Drugs

Repurposing is a major trend. Drugs originally developed for other conditions—like semaglutide, a diabetes and weight-loss drug—are now being tested for Alzheimer’s. GLP-1 drugs like Semaglutide are often called “miracle drugs” due to their remarkable ability to improve the health of people with diabetes and obesity. But researchers continue to find new uses for these pharmaceuticals. There is some evidence that Semaglutide can reduce cognitive decline in people with Alzheimer’s by reducing neuroinflammation and other biological processes believed to be involved in the disease’s pathophysiology. The medication is being tested in two large clinical trials, with results expected by the end of 2025.

2. Small Molecules and Pills

Some oral drugs are nearing the research finish line. Buntanetap, from Annovis Bio, is a “small molecule” drug (a chemical compound with low molecular weight) that is in a new Phase 3 trial after mixed results in earlier studies. AR1001, originally developed for erectile dysfunction, is also in Phase 3 trials for early Alzheimer’s.

3. Biologics and Vaccines

Biologics—complex drugs that are derived from living organisms, like vaccines—are also gaining traction. Beyond Leqembi and Kisunla, several vaccines are in early trials. AC Immune’s ACI-24.060 is being tested in people with Down syndrome and those at risk for Alzheimer’s. Other vaccine candidates like ALZN-002 and GV1001 are in Phase 1 and 3 trials, respectively.

4. Stem Cell and Immune Therapies

Experimental therapies like laromestrocel (a stem cell treatment) and troculeucel (derived from white blood cells that destroy infected disease cells) are being explored, though their efficacy remains uncertain.

Despite progress in the development of new medications for Alzheimer’s, many challenges remain. For one, recruitment of patients for clinical trials is difficult—over 50,000 participants are needed globally. Moreover, many drugs still fail in late-stage trials, and safety concerns (especially with biologics) persist.

Access is another problem. Antibody treatments require specialized diagnostics and monitoring, and costs are high—Leqembi lists at $26,500/year. While Medicare covers these drugs, private insurance coverage is less dependable.

From a pharma perspective, 2025 is a year for cautious optimism. We now have two FDA-approved drugs that can slow Alzheimer’s progression, and a pipeline rich with repurposed agents, vaccines, and novel biologics. Still, these treatments are not cures—they offer modest benefits and are limited to early-stage patients.

For most people living with Alzheimer’s, symptom relief remains the focus. And yet, the shift toward disease modification is real, and growing. The next few years will be critical in determining which of these pipeline candidates can deliver meaningful, accessible, and safe improvements in care.

Alzheimer’s isn’t solved—but the race is on.