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Hi. My sister in law was diagnosed with early stage Alzheimer’s a few months ago. She’s had 3 infusions of Lequembi, two weeks apart. Is it possible that one minute she’s having a totally lucid conversation with her spouse and me and the next minute she’s asking when she’s going back to the city she lives in, when we are only a few blocks from her home? Could it be from the drug, or is that normal for early stage Alzheimer’s?

Yes in our experience it’s normal to be lucid one moment and not the next. Medications may slow it down a bit in some cases, but sad to say it’s a futile effort. Best of luck to you and your family.
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Reply to MarieRiv
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Keep in mind that all of these meds are not a cure. They slow the progression of the disease. The average amount of time is a few months and less than a year. Speak to the ordering doctor. You need to understand what is being done and if a period of time of quality of life is worth the cost
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Reply to MACinCT
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My sister was diagnosed 2 years ago via a spinal tap to confirm Alzheimers. We did two rounds of Leqembi but stopped because no improvement (got worse) and all she would do was be upset for the entire week leading up to the transfusion. I am not an expert, but what you mention was fairly normal for us in the beginning. Unfortunately the disease progresses so quickly that we had to make arrangements for her to move into an assisted living facility a couple weeks ago. I would tell you not to try and figure out what is normal and what isn't because things change so fast (at least in our case) that it is hard to keep up. Also start early figuring out the long term plan. the last 2 years have been brutal for my sister and our family and unfortunately things will probably not get better for your SIL. I hate to be negative but I wish I knew what to expect a couple years ago. Best of luck.
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Dad’s Alzheimer’s was diagnosed early about 10 years before he died. He was till doing crosswords and all regular activity at the time but had moments of comments that didn’t make sense or not like him. Like asking directions to his home from my son’s home just a few miles away, when he always knew directions anywhere. This was my first obvious sign to me. Next he would forget our names or other details. I had one sister who wanted to quiz him and I told her to stop as I saw it frustrated him. We knew where this journey would end so why try to upset him. He passed away last December at 96 years old. We 6 children just tried to make him happy, make his days simple and enjoy him through every stage
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Skelly1230 Nov 6, 2025
Dad took Memantine and Donezepil through his Alzheimer’s journey.
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It's normal for Alzheimer's. My brother say mutable times a day he wants to go home, when he is at his home.
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dkiely33 Nov 6, 2025
Say mutable?? What does that mean?
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Maybe your SIL is suffering from Lewy Body Dementia. An important feature of this type of dementia is exactly what you are seeing in SIL. Maybe a second opinion is a good idea.

Lequembi is specifically approved for Alzheimer's. If in fact your SIL is suffering from another kind of dementia, I am not sure if this expensive drug is useful for her.
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Reply to Samad1
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Denise, if she stays on this, if you are able to update on how she is doing 6 months in and a year out we would be interested in hearing.

Best wishes to you.
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Reply to brandee
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Hi Denise,

I would say normal but it could also be a side effect of the drug.

Mom had alzheimers for close to 20 years and in early on years she could be very lucid but then confused several hours later.

There are a lot of unknowns about the alzheimers drugs.

I'd be interested in you updating us down the road.
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DeniseV: Prayers forthcoming.
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Reply to Llamalover47
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Why on earth is a drug approved that causes swelling or bleeding in the brain? What sort of proof is there that ANY good comes from such an infusion, that'd be my question!

Lequembi is a mab.....a monoclonal antibody. With that type of drug, the user enters the Wild West as far as side effects go. The doctors administering them have no idea what may happen! The hospitals have no idea how to treat the side effects, especially when the BRAIN is involved!

I'll give you an example. I was given a mab.....Remicade.....in an effort to calm my immune system down after immunotherapy (another mab) nearly wiped out my vestibular system. The Remicade caused SEVERE floaters to appear in my eyes that still haven't gone away, nearly 3 yrs later. Nobody knows why, either, it wasn't on The Extensive List Of Possible Side Effects of Remicade. When I told the nurse my entire field of vision was FILLED with thousands of black floaters, she told me they were "just stabbing in the dark" to try to help me. That particular Stab In The Dark cost me some of my vision, permanently.

I suggest your SIL reconsider being a guinea pig for yet another Stab in the Dark mab that may cause her more side effects than it cures. To date, there has been NO CURE for Alzheimer's and no known medication to slow it down, either. If this mab further destroys her already compromised brain, then what?????

Don't take these types of infusions lightly. NOBODY understands how medications are going to work that are intended to ramp up ones own immune system! Only if a person has been given a few months to live with a metastatic cancer diagnosis should they take the risk, imo, as someone in that very position has done. Yes, the mabs saved my life for now, but at a very high cost of permanent disabilty and no relief FROM them. Brand new treatments with THESE possible side effects are way too risky to undertake, imo.

AD is and always will be a brand new cognitive situation hour to hour.

Best of luck to your SIL
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Reply to lealonnie1
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"The most common side effects of Leqembi include: ARIA (amyloid-related imaging abnormalities): Swelling or bleeding in the brain, Headache, Nausea, and Infusion reactions. "

This via the internet which will give you reams of information on the drug, one used to treat amyloid plaques in early Alzheimer's disease.

Whether or not this could be a result of TAKING this infusion would be a question for the Medical team, and the truth is that even they may not know. If the symptoms you suggest occurred WITH the taking of this drug, and prior TO taking it, this relative was ALWAYS without any cognizant speech, but NOW has episodes of rationality --it sounds like some improvement to report to the medical team and to discuss with them.

This is a newer drug, one that is enormously expensive. This drug won't be administered without follow-through and follow-up I would think.

I hope you will discuss and will update us what the best guess are. Sadly, with Alzheimer's almost EVERYTHING is best guesses.
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DeniseV Nov 2, 2025
Thank you. Appreciate your feedback.
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I put your exact question into ChatGPT because of the medication:

"That kind of fluctuation — being clear and oriented one moment, and then suddenly confused about where she is — can, unfortunately, be typical of early Alzheimer’s. People in the early stages often have “good days and bad days” or even “good hours and bad hours.” Their ability to recall or stay oriented can vary depending on fatigue, stress, time of day (especially late afternoon/evening, known as sundowning), hydration, or other medications.

HOWEVER, since she recently started Leqembi (lecanemab) infusions, it’s also wise to consider potential side effects or interactions:

Leqembi can cause brain swelling or small brain bleeds (ARIA-E or ARIA-H) in a small percentage of patients. These can sometimes lead to temporary confusion, disorientation, or behavioral changes.

The onset of these symptoms doesn’t necessarily mean the drug is unsafe for her, but it does warrant evaluation — especially if the confusion seems more sudden or pronounced than before.

What to do:

Contact her neurologist or memory care specialist promptly and describe the pattern — how often it happens, how long it lasts, and when it began relative to her infusions.

Ask whether an MRI is needed; MRIs are routinely done to monitor for ARIA in patients receiving Leqembi.

Keep a simple daily log of her mental clarity, sleep, meals, and infusion dates. This can help the doctor see whether the confusion correlates with the treatment schedule."

I hope this helps!
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Reply to Geaton777
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DeniseV Nov 2, 2025
Thank you. We are keeping track.
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