Axsome Therapeutics (AXSM) Q1 2026 earnings summary

Executive summary

• Achieved total revenue of $191.2 million in Q1 2026, up 57% year-over-year, driven by AUVELITY, SUNOSI, and SYMBRAVO, with AUVELITY net revenue at $153.2 million (+59% YoY), SUNOSI at $33.9 million (+34% YoY), and SYMBRAVO at $4.1 million.

• AUVELITY received FDA approval for agitation in Alzheimer's disease, expanding its label and market potential, with commercial launch set for June 2026.

• Expanded sales force and improved payer coverage across all marketed products, with AUVELITY at 86%, SUNOSI at 83%, and SYMBRAVO at 57%.

• Advanced R&D pipeline with multiple Phase 3 trials, NDA for AXS-12 in narcolepsy submitted, and acquisition of AXS-20 for schizophrenia and Tourette syndrome.

• Net loss for Q1 2026 was $64.5 million ($1.26/share), reflecting higher SG&A and R&D expenses.

Financial highlights

• Total Q1 2026 revenue: $191.2 million, up from $121.5 million in Q1 2025 (+57%).

• AUVELITY net revenue: $153.2 million (+59% YoY); SUNOSI: $33.9 million (+34% YoY); SYMBRAVO: $4.1 million.

• Net loss: $64.5 million ($1.26/share), compared to $59.4 million ($1.22/share) in Q1 2025.

• Cash and equivalents: $305.1 million at March 31, 2026.

• R&D expenses: $52.7 million, including one-time acquisition expense; SG&A expenses: $185 million, up from $120.8 million YoY.

Outlook and guidance

• Peak sales guidance: AUVELITY at least $8 billion (split between MDD and Alzheimer's agitation), SUNOSI $300–500 million, SYMBRAVO $500 million–$1 billion.

• Current cash expected to fund operations into cash flow positivity under the current plan.

• AUVELITY commercial launch for Alzheimer's agitation indication set for June 2026.

• Multiple late-stage clinical milestones and pivotal trial readouts expected in 2026–2027.

• Management anticipates continued revenue growth and improving operating leverage in 2026.