Snapshot · The Peter Attia Drive
Lecanemab and donanemab each cost approximately $26,000 per year for the drug alone, with additional administration fees ranging from $400 to $10,000 per infusion.
Where this was said
At 1:01:41 · chapter starts 1:00:00
Aducanumab's approval in July 2021 was one of the most controversial FDA decisions in memory: the agency overruled its own advisory board, which found the amyloid-lowering effects did not translate reliably into clinical benefit. Gayatri Devi was nonetheless among the first physicians to prescribe it, applying her personal rule: would she want this drug if she had Alzheimer's herself [1] — Gayatri Devi "The other thing, Peter, I always ask myself anytime a new drug comes out is, would I want this drug? If I had Alzheimer's now, knowing ever…" 1:00:59 ? Her answer was yes — reasoning that even a small clinical benefit combined with disease-modifying amyloid clearance was worth trying, especially if the ARIA risk could be mitigated with slow titration. The drug was ultimately pulled from the market not because of safety failures but because the post-approval monitoring obligations became financially unviable for Biogen, leaving only lecanemab and donanemab in the field.
Anti-amyloid antibodies clear amyloid not just from brain substrate but also from the walls of small brain arteries. This disrupts vascular integrity, causing fluid leakage (ARIA-E, edema) and then actual blood extravasation (ARIA-H, hemorrhage). In severe cases with blood thinners or large vessel disruption, it can be fatal.
Spencer Greenberg and Jeremy Stevenson analyzed almost 500 self-improvement techniques and found they all reduce to just 12 underlying psychological drivers.
Cold exposure has good short-term alertness benefits but the evidence base for long-term health benefits is much weaker than popularly believed.
In a randomized study of 20 habit-formation techniques run on hundreds of people, almost none of the techniques produced statistically meaningful results.
People given a tiny-habit fallback option (e.g. 10 squats instead of gym) were actually MORE successful at completing the full habit, not less.
The most effective habit-formation technique was 'habit reflection' — recalling a past successful habit, writing down what helped, then applying those lessons to a new habit.
A study found that simply scheduling enjoyable activities was as effective as standard cognitive behavioral therapy for depression, leading to its own therapy called behavioral activation.
The 'worry time' technique — deferring all worries to a designated time of day — helps people realize they have more control over worry than they thought and reveals it is less useful than it feels.
A study found that participants told to try to stay awake while in bed fell asleep faster than participants told to try to sleep — illustrating the paradox of direct effort.
Spencer Greenberg reduced his severe social anxiety dramatically in roughly 6 months through a structured exposure therapy hierarchy, culminating in asking strangers for hugs.
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