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Daniel Gibbs had received only four monthly doses of Biogen’s experimental Alzheimer’s drug in a clinical trial in 2017 when he ended up in an intensive care unit. He had an excruciating headache, and his blood pressure was so high that doctors thought he might be having a stroke.

It turned out that the retired Portland, Ore., neurologist ― who had treated Alzheimer’s patients before he was diagnosed with the disease himself in 2015 ― was experiencing some of the worst reported side effects of the drug. Doctors prescribed medicines to lower his blood pressure, which reached 206/116, and later to reduce brain swelling. But for weeks afterward, he struggled to read, follow conversations, and do simple math. He recovered but never again took the Alzheimer’s drug.

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Much of the controversy surrounding the medication, called Aduhelm, has centered on conflicting trial data about whether it slows cognitive decline, its $56,000 annual cost, and the unusual process that led to its June approval. But for all the attention focused on the disputed benefits of the Cambridge biotechnology firm’s medicine, Gibbs says an important aspect of Aduhelm has been downplayed ― its risks.

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