Title

Earning Preview: Axsome Therapeutics Q4 revenue is expected to increase by 63.74%, and institutional views are bullish

Abstract

Axsome Therapeutics will report fourth-quarter and full-year 2025 results on February 23, 2026 Pre-Market; our preview highlights consensus calls for rapid top-line growth, sustained high gross margins, a year-over-year improvement in EPS despite continued investment, and strong analyst conviction powered by product momentum and near-term regulatory catalysts.

Market Forecast

Consensus tracking implies Axsome Therapeutics’ current quarter revenue around $192.63 million, a projected increase of 63.74% year over year, with adjusted EPS estimated at approximately -$0.67, a 34.23% year-over-year improvement based on forecast methodology; EBIT is expected to be about -$32.15 million, improving 31.08% year over year. The company’s own recent indication points to approximately $196.00 million in total product revenue for the quarter, implying roughly 65% year-over-year growth; margin outlook has not been explicitly guided, and consensus does not provide a gross or net profit margin forecast for the period.

The main business is led by product sales, where company commentary and recent trends suggest continued lift from the antidepressant Auvelity and contributions from Sunosi; the setup points to strong revenue run-rate into early 2026 with durable high gross margins observed in recent quarters. The most promising segment by revenue remains products, with Axsome Therapeutics signaling about $196.00 million in Q4 product revenue, up about 65% year over year, supported by anticipated Auvelity net product sales of about $155.10 million.

Last Quarter Review

Axsome Therapeutics’ prior quarter delivered $170.99 million in revenue (up 63.22% year over year), a gross profit margin of 93.03%, GAAP net loss attributable to the parent of $47.23 million with a net profit margin of -27.62%, and adjusted EPS of -$0.94, reflecting a 29.85% year-over-year improvement. A key financial highlight was a revenue outperformance versus estimates by $8.45 million, partially offset by a modest EPS shortfall of $0.07 against the consensus. From a business mix standpoint, product revenue was $169.78 million and royalties were $1.21 million, with products accounting for approximately 99.29% of total revenue and growth in the period broadly in line with the company’s overall 63.22% year-over-year expansion.

Current Quarter Outlook (with major analytical insights)

Main business: product revenue trajectory and profitability mix

The primary engine this quarter remains product revenue, anchored by Auvelity in depression and supported by the broader in-market portfolio. The company’s indication for approximately $196.00 million in Q4 product revenue implies acceleration from the $170.99 million booked last quarter and aligns with robust demand trends noted in recent commentary. Given a reported gross profit margin of 93.03% last quarter, product growth continues to be advantageous for gross margin leverage; however, elevated commercial and development spending keeps EBIT and EPS negative, even as both are improving year over year on scale benefits.

Consensus for the quarter centers on $192.63 million in total revenue and adjusted EPS of approximately -$0.67, reflecting a 34.23% year-over-year improvement. The gap between the company’s indicated product revenue (~$196.00 million) and consensus total revenue (~$192.63 million) is moderate and suggests upside risk to the top line if net revenue recognition matches indicated net product sales and royalties remain consistent. Operating expense dynamics are critical: the prior quarter’s EBIT trajectory and the current estimate of -$32.15 million point to continued, though narrowing, operating losses as the company invests behind commercial execution and advancing late-stage programs.

From a margin-mix perspective, the reliance on high-margin products bodes well for sustaining a gross profit margin near recent levels, while broader profitability will depend on how efficiently sales and marketing investments convert into incremental prescriptions. With product sales representing roughly 99% of revenue last quarter, the overall P&L is highly sensitive to unit growth, new prescriber adoption, and patient persistence trends. Any incremental contribution from royalties would be incremental to margin, but the magnitude is small relative to products.

Most promising business: Auvelity momentum and near-term growth profile

Auvelity’s momentum remains the clearest driver in the quarter, with the company indicating about $155.10 million in net product sales for Q4. This implies that Auvelity represents the majority of the projected product revenue for the period and underscores its role as the key growth vector. Against the backdrop of last quarter’s $169.78 million in total product revenue, Auvelity’s indicated performance suggests continued sequential expansion and deepening market uptake.

The sequential growth narrative points to improved prescriber penetration, patient adds, and better reimbursement coverage. From a financial standpoint, Auvelity’s contribution supports the 63.74% year-over-year revenue growth implied by consensus and the ~65% year-over-year increase indicated by the company’s product revenue outlook. While margin guidance has not been provided, the product skew aligns with sustaining high gross margins, and any incremental efficiencies in salesforce effectiveness or patient access programs could support further improvement in operating leverage.

Looking beyond the quarter’s print, durability of demand and refill dynamics will be watched closely by investors seeking confirmation that the recent run-rate is sustainable. In this quarter, the balance of evidence points toward an upward trajectory for Auvelity sales relative to both internal and external benchmarks, which drives a constructive bias for the top line and for EPS improvement versus last year, despite continued investment.

Stock-price impact factor: near-term regulatory catalyst and operating leverage

A significant catalyst relevant to investor positioning into and after the quarter is the pending regulatory decision for AXS-05 in Alzheimer’s disease agitation, with a Prescription Drug User Fee Act date on April 30, 2026. Analyst commentary highlights the potential for this decision to materially influence sentiment and valuation, with some expecting the approval to open a new revenue stream and potentially drive the share price meaningfully higher. Although this catalyst falls just outside the quarter’s accounting window, it can shape guidance tone and management’s qualitative commentary, both of which are typically key drivers of stock reaction on earnings day.

Operationally, the market will scrutinize whether the company can sustain high gross margins near the prior quarter’s 93.03% while demonstrating sequential control of operating expenses as revenue scales. The forecasted year-over-year improvements in EBIT (31.08%) and EPS (34.23%) signal ongoing leverage, but the absolute levels remain negative, so investor reception may hinge on cadence and directionality. Any delta between the company-indicated product revenue (~$196.00 million) and reported revenue will be an immediate focus, as will color on scripts, payer dynamics, and the forward view for 2026 growth — particularly whether Auvelity can maintain its momentum and how quickly subsequent assets can contribute.

Analyst Opinions

Across the recent sample of institutional commentary, views are overwhelmingly bullish, with a 100% positive skew in published opinions during the review window. Notably, several firms raised price targets while reiterating Buy or Outperform ratings, citing accelerating product revenue, strong Auvelity performance, and a high-impact regulatory catalyst approaching for AXS-05. On January 21, 2026, one major bank lifted its price target to $219 and maintained an Outperform rating, pointing to confidence in growth ahead of mid-year milestones. Another global investment firm adjusted its target to $248 while maintaining a Buy stance on January 6, 2026, acknowledging the enhanced medium-term revenue potential and forward catalysts. Additional institutions have raised targets into the $197.59–$223 range in early January 2026 while maintaining Buy ratings, reinforcing the positive consensus trend into the print.

Research departments and analysts emphasize the same themes: the anticipated inflection in quarterly product revenue toward approximately $196.00 million, consensus-aligned revenue forecasts of $192.63 million suggesting manageable execution risk, and the expected year-over-year improvement in EPS despite continued operating investments. Several analysts highlight Auvelity’s trajectory as the central pillar for near-term growth and call out that even as the company continues to invest across its portfolio, operating leverage should continue to improve as revenue scales. Furthermore, certain coverage notes flag the April 30, 2026 regulatory decision for AXS-05 in Alzheimer’s disease agitation as a substantial medium-term driver, with some frameworks pointing to peak sales potential that could validate higher valuation ranges if approved.

The tone of institutional previews frames a constructive setup into the quarter: top-line growth in the 60%+ range year over year, sustained high gross margins based on the prior quarter’s 93.03%, and EPS improving versus last year even as the company remains in investment mode. Analysts also indicate that quarterly revenue and product updates will carry outsized weight for the stock’s immediate reaction, particularly when compared to EPS, given the centrality of Auvelity’s adoption curve. The absence of bearish institutional calls in the reviewed period, combined with multiple upward price target revisions, supports a majority bullish stance. In aggregate, the dominant view anticipates that Axsome Therapeutics will deliver results consistent with or modestly ahead of consensus on revenue, provide constructive qualitative commentary on demand drivers, and maintain a clear line of sight to the upcoming regulatory milestone, leaving the risk/reward skewed positively in the near to medium term.