Axsome Therapeutics, Inc.
AXSM · Pharmaceutical Preparations · 51.5M shares · +7%/yr ↑ dilution · EDGAR filings ↗
Reference price $249.12 · est. market cap ~$12.8B — last insider sale, 2026-06-11 (estimated from the dated SEC Form 4 price × shares outstanding — not a live quote)
Grade
C64Fast-growing commercial CNS biopharma with three approved drugs and multiple positive late-stage readouts, but still deeply unprofitable and highly levered.
Strengths
- Commercial traction: $638.5M product revenue, +66% growth (revenue growth 78th pct), interest coverage 96th pct, healthy cash runway (~13.8 quarters, 79th pct)
- Strong clinical de-risking: positive Phase 3 GEMINI in MDD (p=0.002) and AXS-07 migraine co-primaries, plus accepted AXS-05 Alzheimer's-agitation sNDA on Priority Review (PDUFA Apr-2026)
Risks
- Still loss-making: net margin -28.7%, ROE -2.07 (12.9 pct) and debt/equity 1.33 (87.9 pct) reflect a levered, pre-profit balance sheet
- Terminated open-label safety extensions in AD agitation/TRD are operational negatives, and profitability remains unproven
Notable findings
- Fund exitedNotable fund(s) exited this quarter: VANGUARD GROUP INC
- Net lossNet loss (net margin -28.7%)
- Exec changeRecent 8-K item 5.02 8-K ↗
- Cash burnNegative free cash flow (-93.9M)
- Strong balance sheetStrong balance sheet — $323M cash & investments, ~14 quarters of runway
- Trial readout soonUpcoming trial readout ~2026-12 — PHASE3 · Binge-Eating Disorder
- Notable holderHeld by 6 notable fund(s): FMR LLC, STATE STREET CORP, GOLDMAN SACHS GROUP INC +3 more (as of 2026-03-31)
- Insider sellingInsider selling — 23 open-market sale(s) by 8 insider(s) (cluster of 8 insiders, ~$76M, last 6mo) Form 4 ↗
Quarterly revenue
Last 4 quarters · from SEC filings.
Key metrics
Operating margin
-26.1%
Net margin
-28.7%
Return on equity
-207.5%
Return on assets
-26.6%
ROIC
-63.9%
Revenue growth (QoQ)
-2.4%
Debt / equity
1.3×
Interest coverage
10.5×
Current ratio
1.6×
Free cash flow
-$94M
Tangible book value
$36M
Cash & investments
$323M
Cash runway
14q
Stock comp / revenue
14.7%
Insider transactions · last 18 months
| Date | Insider | Type | Shares | Price |
|---|---|---|---|---|
| 2026-06-11 | JEFFS ROGER | Sell | 286 | $249.12 |
| 2026-06-10 | Mahony Susan | Sell | 300 | $246.18 |
| 2026-06-10 | JEFFS ROGER | Sell | 286 | $246.18 |
| 2026-06-10 | Coleman Mark | Sell | 643 | $249.00 |
| 2026-06-09 | Pizzie Nick | Sell | 33K | $240.09 |
| 2026-06-09 | Mahony Susan | Sell | 300 | $237.21 |
| 2026-06-09 | TABUTEAU HERRIOT | Option exercise | 50K | $4.95 |
| 2026-06-09 | TABUTEAU HERRIOT | Sell | 50K | $241.01 |
| 2026-06-09 | Pizzie Nick | Option exercise | 33K | $3.50 |
| 2026-06-08 | Mahony Susan | Option exercise | 1.4K | — |
| 2026-06-08 | Coleman Mark | Option exercise | 1.4K | — |
| 2026-06-08 | JEFFS ROGER | Option exercise | 1.4K | — |
| 2026-06-08 | Saad Mark E | Option exercise | 1.4K | — |
| 2026-06-02 | Coleman Mark | Sell | 5.5K | $223.39 |
| 2026-06-01 | Coleman Mark | Sell | 6.0K | $230.30 |
| 2026-05-29 | Coleman Mark | Sell | 6.0K | $233.46 |
| 2026-05-05 | Jacobson Mark L. | Option exercise | 233 | $12.95 |
| 2026-05-05 | Jacobson Mark L. | Sell | 233 | $228.18 |
| 2026-05-04 | Jacobson Mark L. | Sell | 4.5K | $227.94 |
| 2026-05-04 | Jacobson Mark L. | Option exercise | 4.5K | $12.95 |
| 2026-04-22 | Maizel Ari | Option exercise | 7.5K | $70.73 |
| 2026-04-22 | Maizel Ari | Sell | 7.5K | $182.42 |
| 2026-02-26 | Coleman Mark | Sell | 25K | $161.11 |
| 2026-02-26 | Jacobson Mark L. | Sell | 35K | $161.88 |
| 2026-02-26 | Jacobson Mark L. | Option exercise | 35K | $2.85 |
| 2026-02-23 | Coleman Mark | Option exercise | 6.2K | $4.95 |
| 2026-02-20 | Coleman Mark | Option exercise | 12K | $4.95 |
| 2026-02-10 | Coleman Mark | Option exercise | 5.2K | $8.02 |
| 2026-02-02 | TABUTEAU HERRIOT | Option exercise | 32K | $8.02 |
| 2026-02-02 | TABUTEAU HERRIOT | Sell | 32K | $185.60 |
| 2026-01-22 | Pizzie Nick | Option exercise | 12K | $3.50 |
| 2026-01-22 | Pizzie Nick | Sell | 12K | $187.92 |
| 2026-01-21 | Maizel Ari | Option exercise | 7.5K | $70.73 |
| 2026-01-21 | Maizel Ari | Sell | 7.5K | $184.44 |
| 2026-01-07 | TABUTEAU HERRIOT | Option exercise | 31K | $8.02 |
| 2026-01-07 | TABUTEAU HERRIOT | Sell | 31K | $170.38 |
| 2026-01-06 | TABUTEAU HERRIOT | Sell | 29K | $172.33 |
| 2026-01-06 | TABUTEAU HERRIOT | Option exercise | 29K | $8.02 |
| 2026-01-05 | TABUTEAU HERRIOT | Sell | 79K | $171.28 |
| 2026-01-05 | TABUTEAU HERRIOT | Option exercise | 79K | $8.02 |
| 2025-12-31 | Saad Mark E | Option exercise | 6.2K | $8.02 |
| 2025-12-31 | Saad Mark E | Sell | 6.2K | $165.18 |
| 2025-12-31 | Saad Mark E | Option exercise | 31K | $4.95 |
| 2025-12-31 | Saad Mark E | Sell | 31K | $165.18 |
| 2025-12-04 | TABUTEAU HERRIOT | Sell | 11K | $148.18 |
| 2025-12-04 | TABUTEAU HERRIOT | Option exercise | 11K | $8.02 |
| 2025-12-03 | TABUTEAU HERRIOT | Option exercise | 20K | $8.02 |
| 2025-12-03 | TABUTEAU HERRIOT | Sell | 20K | $146.94 |
| 2025-12-02 | TABUTEAU HERRIOT | Option exercise | 49K | $8.02 |
| 2025-12-02 | TABUTEAU HERRIOT | Sell | 49K | $144.59 |
| 2025-11-05 | TABUTEAU HERRIOT | Option exercise | 22K | $8.02 |
| 2025-11-05 | TABUTEAU HERRIOT | Sell | 22K | $134.49 |
| 2025-11-04 | TABUTEAU HERRIOT | Sell | 50K | $133.79 |
| 2025-11-04 | TABUTEAU HERRIOT | Option exercise | 50K | $8.02 |
| 2025-11-03 | TABUTEAU HERRIOT | Option exercise | 92K | $8.02 |
| 2025-11-03 | TABUTEAU HERRIOT | Sell | 92K | $132.34 |
| 2025-10-08 | TABUTEAU HERRIOT | Sell | 13K | $118.84 |
| 2025-10-08 | TABUTEAU HERRIOT | Option exercise | 13K | $8.02 |
| 2025-10-07 | TABUTEAU HERRIOT | Option exercise | 13K | $8.02 |
| 2025-10-07 | TABUTEAU HERRIOT | Sell | 13K | $118.77 |
| 2025-10-06 | TABUTEAU HERRIOT | Sell | 19K | $120.17 |
| 2025-10-06 | TABUTEAU HERRIOT | Option exercise | 19K | $8.02 |
| 2025-09-22 | Jacobson Mark L. | Option exercise | 10K | $2.85 |
| 2025-09-22 | Jacobson Mark L. | Sell | 10K | $115.96 |
| 2025-09-16 | Jacobson Mark L. | Option exercise | 15K | $4.85 |
| 2025-09-16 | Jacobson Mark L. | Sell | 5.8K | $116.19 |
| 2025-09-16 | Jacobson Mark L. | Option exercise | 25K | $4.95 |
| 2025-09-16 | Jacobson Mark L. | Sell | 40K | $114.23 |
| 2025-09-16 | TABUTEAU HERRIOT | Option exercise | 20K | $8.02 |
| 2025-09-16 | TABUTEAU HERRIOT | Sell | 20K | $114.19 |
| 2025-09-15 | TABUTEAU HERRIOT | Option exercise | 15K | $8.02 |
| 2025-09-15 | TABUTEAU HERRIOT | Sell | 15K | $117.37 |
| 2025-09-12 | TABUTEAU HERRIOT | Sell | 28K | $118.96 |
| 2025-09-12 | TABUTEAU HERRIOT | Option exercise | 28K | $8.02 |
| 2025-09-08 | Coleman Mark | Buy | 800 | $127.20 |
| 2025-09-08 | Coleman Mark | Buy | 287 | $127.30 |
| 2025-09-08 | Coleman Mark | Buy | 488 | $127.40 |
| 2025-09-05 | Saad Mark E | Option exercise | 9.1K | $9.00 |
| 2025-09-05 | Saad Mark E | Sell | 9.1K | $125.07 |
| 2025-09-02 | JEFFS ROGER | Sell | 13K | $123.68 |
| 2025-08-29 | JEFFS ROGER | Sell | 20K | $121.27 |
| 2025-08-28 | JEFFS ROGER | Sell | 20K | $121.60 |
| 2025-08-27 | JEFFS ROGER | Sell | 20K | $122.30 |
| 2025-08-26 | JEFFS ROGER | Sell | 20K | $120.03 |
| 2025-08-22 | JEFFS ROGER | Sell | 17K | $120.08 |
| 2025-06-23 | Murdock Hunter R. | Option exercise | 6.0K | $29.91 |
| 2025-06-23 | Murdock Hunter R. | Sell | 6.0K | $100.12 |
| 2025-06-20 | Murdock Hunter R. | Option exercise | 7.5K | $29.91 |
| 2025-06-20 | Murdock Hunter R. | Sell | 7.5K | $102.47 |
| 2025-06-18 | Murdock Hunter R. | Sell | 7.5K | $100.90 |
| 2025-06-18 | Murdock Hunter R. | Option exercise | 7.5K | $29.91 |
| 2025-06-17 | Murdock Hunter R. | Option exercise | 7.5K | $29.91 |
| 2025-06-17 | Murdock Hunter R. | Sell | 7.5K | $100.26 |
| 2025-06-16 | Murdock Hunter R. | Option exercise | 7.5K | $29.91 |
| 2025-06-16 | Murdock Hunter R. | Sell | 7.5K | $102.42 |
| 2025-06-09 | Jacobson Mark L. | Sell | 25K | $110.44 |
| 2025-06-09 | Jacobson Mark L. | Option exercise | 25K | $8.02 |
| 2025-05-28 | Coleman Mark | Sell | 3.8K | $103.43 |
| 2025-05-28 | Jacobson Mark L. | Option exercise | 20K | $6.47 |
| 2025-05-28 | Jacobson Mark L. | Sell | 20K | $103.45 |
| 2025-05-27 | Coleman Mark | Sell | 3.8K | $105.47 |
| 2025-05-27 | Jacobson Mark L. | Option exercise | 21K | $6.47 |
| 2025-05-27 | Jacobson Mark L. | Sell | 21K | $104.66 |
| 2025-05-20 | Coleman Mark | Sell | 3.0K | $107.49 |
| 2025-02-14 | Pizzie Nick | Option exercise | 3.0K | $3.50 |
| 2025-02-14 | Pizzie Nick | Sell | 3.0K | $131.07 |
| 2025-02-13 | Pizzie Nick | Option exercise | 12K | $3.50 |
| 2025-02-13 | Pizzie Nick | Sell | 12K | $129.86 |
| 2025-01-03 | Coleman Mark | Option exercise | 9.1K | $9.00 |
All non-derivative Form 4 activity (SEC), newest first.
Clinical trials
| Trial | Title | Phase | Status | Primary completion |
|---|---|---|---|---|
| NCT06413420 ↗ | SUNOSI® (Solriamfetol) Pregnancy Registry Narcolepsy, Obstructive Sleep Apnea | — | Recruiting | 2029-09-01 |
| NCT07484217 ↗ | Clinical Assessment of Response in the Treatment of Depression With Daytime Sleepiness Using Solriamfetol Major Depressive Disorder With Excessive Daytime Sleepiness Symptoms | PHASE3 | Recruiting | 2028-12-01 |
| NCT07637162 ↗ | Open-Label Safety Study of AXS-14 in Subjects With Fibromyalgia Fibromyalgia | PHASE3 | Enrolling By Invitation | 2028-05-01 |
| NCT07398417 ↗ | Fibromyalgia Response With Esreboxetine Evaluated Using a Randomized Withdrawal Research Design Fibromyalgia | PHASE3 | Recruiting | 2028-03-01 |
| NCT06878976 ↗ | Open-Label Safety Study of Solriamfetol in Subjects With Binge Eating Disorder Binge-Eating Disorder | PHASE3 | Enrolling By Invitation | 2026-12-01 |
| NCT06568367 ↗ | Studying Solriamfetol Modulation of TAAR-1, Dopamine, and Norepinephrine in Shift Work Disorder (SUSTAIN) Excessive Sleepiness, Shift-work Disorder | PHASE3 | Recruiting | 2026-12-01 |
| NCT06223880 ↗ | A Study to Evaluate the Efficacy of AXS-05 Compared to Bupropion in Preventing the Relapse of Depressive Symptoms Major Depressive Disorder | PHASE4 | Recruiting | 2026-03-01 |
| NCT06413433 ↗ | Elucidating TAAR-1, Dopamine, and Norepinephrine in Binge Eating Disorder Using Solriamfetol Binge-Eating Disorder | PHASE3 | Recruiting | 2025-12-01 |
| NCT06736509 ↗ | An Open-Label Study to Assess the Long-term Safety of AXS-05 in Subjects With Dementia of the Alzheimer's Type, ADVANCE-2 and ACCORD-2 Extension Study Agitation in Patients With Dementia of the Alzheimer's Type, Alzheimer Disease | PHASE3 | Terminated | 2025-02-17 |
| NCT05972044 ↗ | A Study to Assess the Efficacy and Safety of Solriamfetol in Subjects With ADHD (FOCUS) ADHD | PHASE3 | Completed | 2025-02-07 |
| NCT06360419 ↗ | Progressing TAAR-1, Dopamine, and Norepinephrine in Depression Using Solriamfetol Major Depressive Disorder | PHASE3 | Completed | 2024-12-31 |
| NCT04947553 ↗ | A Study to Assess the Long-term Safety and Efficacy of AXS-05 in Subjects With Alzheimer's Disease Agitation Agitation in Patients With Dementia of the Alzheimer's Type, Alzheimer Disease | PHASE3 | Completed | 2024-12-03 |
| NCT05550207 ↗ | Open-Label Study of AXS-07 for the Acute Treatment of Migraine in Adults With a Prior Inadequate Response to an Oral CGRP Inhibitor (EMERGE) Migraine | PHASE3 | Completed | 2024-11-27 |
| NCT05557409 ↗ | A Study to Assess the Efficacy and Safety of AXS-05 in Subjects With Alzheimer's Disease Agitation Agitation in Patients With Dementia of the Alzheimer's Type, Alzheimer Disease | PHASE3 | Completed | 2024-11-21 |
| NCT05113745 ↗ | A Study to Assess the Long-term Efficacy and Safety of AXS-12 (Reboxetine) in Subjects With Narcolepsy (ENCORE) Narcolepsy, Cataplexy | PHASE3 | Completed | 2024-11-15 |
| NCT05059223 ↗ | A Study to Assess the Efficacy and Safety of AXS-12 (Reboxetine) in Patients With Narcolepsy Narcolepsy, Cataplexy | PHASE3 | Completed | 2024-03-15 |
| NCT04797715 ↗ | Assessing Clinical Outcomes in Alzheimer's Disease Agitation Agitation in Patients With Dementia of the Alzheimer's Type, Alzheimer Disease | PHASE3 | Completed | 2022-11-21 |
| NCT04789174 ↗ | Solriamfetol's Effect on Cognitive Health in Apnea Participants During a Randomized Placebo-controlled Study Excessive Daytime Sleepiness, Obstructive Sleep Apnea | PHASE4 | Completed | 2022-09-19 |
| NCT05008341 ↗ | Evaluate Sunosi® PK in Breast Milk and Plasma of Healthy Postpartum Women Following Single Dose Oral Administration Narcolepsy, Obstructive Sleep Apnea | PHASE1 | Completed | 2022-04-15 |
| NCT04634669 ↗ | Open-Label Safety Study of AXS-05 in Subjects With TRD (EVOLVE) Treatment Resistant Depression, Major Depressive Disorder | PHASE2 | Terminated | 2022-02-18 |
Source: ClinicalTrials.gov (U.S. NIH) · active studies first.
Notable events (8-K)
Recent filings
| Form | Filed | Period | Accession |
|---|---|---|---|
| 8-K | 2026-06-09 | 2026-06-05 | 0001193125-26-264047 ↗ |
| 8-K | 2026-06-09 | 2026-06-05 | 0001193125-26-264043 ↗ |
| 8-K | 2026-06-03 | 2026-06-03 | 0001193125-26-254708 ↗ |
| 8-K | 2026-05-04 | 2026-05-04 | 0001193125-26-202506 ↗ |
| 10-Q | 2026-05-04 | 2026-03-31 | 0001193125-26-204274 ↗ |
| 8-K | 2026-04-30 | 2026-04-30 | 0001193125-26-197857 ↗ |
| 8-K | 2026-04-01 | 2026-04-01 | 0001193125-26-135669 ↗ |
| 8-K | 2026-02-23 | 2026-02-23 | 0001193125-26-062421 ↗ |
| 10-K | 2026-02-23 | 2025-12-31 | 0001193125-26-064267 ↗ |
| 8-K | 2026-02-17 | 2026-02-17 | 0001193125-26-053009 ↗ |
| 8-K | 2026-01-12 | 2026-01-12 | 0001193125-26-009744 ↗ |
| 8-K | 2025-12-31 | 2025-12-31 | 0001193125-25-337644 ↗ |