Clearance of pathogenic amyloid-β (Aβ) deposits from patient brains is being investigated as a treatment approach for Alzheimer disease (AD). However, Phase III trial results of Aβ-targeting monoclonal antibodies have been disappointing. Using AD transgenic mice, Busche et al. reveal that although Aβ-targeting antibodies reduce amyloid pathology, they unexpectedly aggravate neuronal dysfunction, increase numbers of pathologically hyperactive neurons and promote abnormal synchrony of cortical activity.