Axsome Therapeutics Inc. reported fourth‑quarter 2025 revenue of $196.0 million, a 66% increase from $118.8 million in Q4 2024. The jump was driven by strong sales of its three commercial products—Auvelity ($155.1 million), Sunosi ($36.7 million), and Symbravo ($4.1 million)—which together accounted for the majority of the revenue growth.
The company posted a GAAP earnings‑per‑share loss of $0.56, beating the consensus estimate of a $0.68 loss. The beat was largely due to disciplined cost management that offset the higher commercial spend required to support the accelerated sales of Auvelity and Sunosi. However, the non‑GAAP EPS of –$0.71 fell short of the consensus estimate of –$0.68, reflecting the impact of increased sales‑force expansion and a direct‑to‑consumer advertising campaign.
Axsome’s operating margin remained negative, but the company’s gross‑to‑net discount for Auvelity and Sunosi was in the high‑40% range in 2025, with expectations of a shift to the mid‑50% range in 2026 due to typical Q1 dynamics. The higher discount rate, combined with the expanded commercial spend, contributed to the margin compression seen in the quarter.
Chief Executive Officer Herriot Tabuteau said the results “demonstrate strong commercial momentum across our marketed products and advancement of our CNS pipeline.” Chief Financial Officer Nick Pizzie noted that the company’s cash position of $322.9 million is sufficient to fund operations into cash‑flow positivity, underscoring management’s confidence in sustaining growth while working toward profitability.
Investors reacted cautiously, noting that while revenue met or exceeded expectations, the non‑GAAP EPS miss and the higher commercial spend signal that the company is still investing heavily to accelerate market share. The market’s tempered response reflects a focus on the company’s ability to translate commercial momentum into profitability in the near term.
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