Axsome Therapeutics, Inc. AXS-05 R&D Day CNS Pipeline Overview

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AXS-05 R&D Day April 24, 2018 Axsome Therapeutics, Inc. AXS-05 R&D Day CNS Pipeline Overview Herriot Tabuteau, MD Chief Executive Officer Axsome Therapeutics, Inc. New York City 3

Forward-Looking Statements & Safe Harbor Certain information contained in this presentation may include forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. We may, in some cases, use terms such as predicts, believes, potential, continue, estimates, anticipates, expects, plans, intends, may, could, might, will, should or other words that convey uncertainty of future events or outcomes to identify these forward-looking statements. In particular, the Company s statements regarding trends and potential future results are examples of such forward-looking statements. The forwardlooking statements include risks and uncertainties, including, but not limited to, the success, timing and cost of our ongoing clinical trials and anticipated clinical trials for our current product candidates, including statements regarding the timing of initiation and completion of the trials, interim analyses and receipt of interim results; the timing of and our ability to obtain and maintain U.S. Food and Drug Administration or other regulatory authority approval of, or other action with respect to, our product candidates; the Company s ability to obtain additional capital necessary to fund its operations; the Company s ability to generate revenues in the future; the Company s ability to successfully defend its intellectual property or obtain the necessary licenses at a cost acceptable to the Company, if at all; the successful implementation of the Company s research and development programs; the enforceability of the Company s license agreements; the acceptance by the market of the Company s product candidates, if approved; and other factors, including general economic conditions and regulatory developments, not within the Company s control. These factors could cause actual results and developments to be materially different from those expressed in or implied by such statements. Forward-looking statements are not guarantees of future performance, and actual results may differ materially from those projected. The forward-looking statements are made only as of the date of this presentation and the Company undertakes no obligation to publicly update such forward-looking statements to reflect subsequent events or circumstance. This presentation also contains estimates and other statistical data made by independent parties and by us relating to market size and other data about our industry. This data involves a number of assumptions and limitations, and you are cautioned not to give undue weight to such estimates. Neither we nor any other person makes any representation as to the accuracy or completeness of such data or undertakes any obligation to update such data after the date of this presentation. In addition, these projections, assumptions and estimates are necessarily subject to a high degree of uncertainty and risk. 2

Our Candidates and Pipeline Five differentiated clinical-stage assets targeting significant and growing markets. Patent protection to 2034, worldwide rights. Product Candidate Preclinical Phase 1 Phase 2 Phase 3 AXS-05 (DM + BUP) AXS-09 (DM + S-BUP) AXS-02 (DZT) AXS-07 (MoSEIC Mx + Riz) AXS-06 (MoSEIC Mx + Eso) Treatment Resistant Depression: Fast Track Granted Agitation in Alzheimer s Disease: Fast Track Granted Smoking Cessation CNS Disorders Knee OA with BMLs: SPA Received; Fast Track Granted CLBP with MCs Migraine OA and RA Ongoing Ongoing Duke University Collaboration Ongoing Abbreviations: BML = Bone Marrow Lesions; BUP = Bupropion; CLBP = Chronic Low Back Pain; DM = Dextromethorphan; DZT = Disodium Zoledronate Tetrahydrate; Eso = Esomeprazole; MC = Modic Changes; Mx = Meloxicam; OA = Osteoarthritis; RA = Rheumatoid Arthritis; Riz = Rizatriptan; S-BUP = Esbupropion; SPA = Special Protocol Assessment. 4

AXS-05: Mechanisms of Action and Relevant Indications Pharmacodynamic Synergy Relevant Indications 1 Mechanism of Action NMDA Receptor Antagonist DM BUP AXS-05 DM+BUP Related Agents 2 Ketamine Memantine (Namenda ) Sigma-1R Agonist Fluvoxamine (Luvox ) Donepezil (Aricept ) Norepinephrine Reuptake Inhibitor Serotonin Reuptake Inhibitor Duloxetine (Cymbalta ) Venlafaxine (Effexor ) Escitalopram (Lexapro ) Fluoxetine (Prozac ) Sertraline (Zoloft ) Dopamine Reuptake Inhibitor Bupropion (Wellbutrin ) Nicotinic ACh Receptor Antagonist Bupropion (Wellbutrin ) DM = Dextromethorphan; BUP = Bupropion. Present Relevant 1. Indications listed are associated with the mechanism of action and are not related to either DM or BUP, unless specifically noted. 2. Agents do not contain DM or BUP, unless specifically noted. 5

AXS-05: Treatment Resistant Depression 3M patients in the U.S. 1-3 1% $150-300M * FDA Fast Track Designation Phase 3 ongoing Interim analysis for futility anticipated 2Q 2018 Interim analysis for efficacy anticipated 2H 2018 Full topline results 2H 2018-1H 2019 *Annual estimate for illustrative purposes. 1 Marcus SC, Olfson M. Arch Gen Psychiatry 2010;67:1265-1273. 2 Rush AJ, et al. Am J Psychiatry 2006;163:1905-1917. 3 U.S. Census Bureau, Population April 1, 2010 to July 1, 2013. 6

AXS-05: Agitation in Alzheimer s Disease 2M patients in the U.S. 1,2 1% $100-200M * FDA Fast Track Designation Phase 2/3 ongoing Interim analysis for futility anticipated 2H 2018 Interim analysis for efficacy anticipated 2019 *Annual estimate for illustrative purposes. 1 Ryu, SH, et al. Am J Geriatr Psychiatry. 2005;13:976-983. 2 Hebert, LE, et al. Neurology. 2013;80:1778-1783. 7

AXS-05: Agitation in Alzheimer s Disease 40M smokers in the U.S. 28M attempting to quit 1,2 1% $1.3-2.7B * Phase 2 initiated in collaboration with Duke University *Annual estimate for illustrative purposes. 1 U.S. Department of Health and Human Services. The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General. 2014. 2 Hughes JR, et al. Addiction. 2004;99(1):29-38. 8

AXS-09: Esbupropion + DM Esbupropion and DM fixed-dose combination Esbupropion is the chirally pure S-enantiomer of bupropion. Phase 1 trial completed: Pharmacokinetic trial of AXS-09, R-bupropion and dextromethorphan, single-entity S-bupropion, or single-entity R-bupropion Substantial increases in DM plasma concentrations with AXS-09 (p<0.0001 day 1 versus day 8) DM concentrations with AXS-09 comparable to AXS-05 AXS-09 was well tolerated To be developed in future CNS indications Product Candidate AXS-09 (DM + S-BUP) Preclinical Phase 1 Phase 2 Phase 3 CNS Disorders Abbreviations: DM = Dextromethorphan; S-BUP = Esbupropion. 9

AXS-07: MoSEIC Meloxicam + Rizatriptan for Migraine 15M Triptan U.S. Rx s written per year 1% $100M * Phase 3 initiation anticipated in 2018 MoSEIC meloxicam delivers rapid, IV-like absorption with oral delivery, combined with 20- hour half-life. Potential for superior efficacy as compared to current treatments. *Annual estimate for illustrative purposes. 10

Broad Intellectual Property 23 Issued U.S. Patents 1 Issued O-U.S. Patent Claims extending to 2034 >40 pending 1 issued U.S. Patent Claims extending to 2036 >10 pending Proprietary Manufacturing Drug Product Formulation AXS-05 AXS-09 MoSEIC Meloxicam (AXS-07, AXS-06) Proprietary Manufacturing Drug Product Formulation AXS-02 75 Issued U.S. Patents* 14 Issued O-U.S. Patents Claims extending to 2034 >60 pending Proprietary Manufacturing API Synthesis *Claims cover AXS-02 and related substances and disease indications. 11

Clinical Milestones Product Candidate AXS-05 (DM + BUP) Indication 2018 2019 TRD STRIDE-1 interim analysis (2Q 2018) STRIDE-1 interim efficacy analysis (2H 2018) STRIDE-1 top-line results (2H 2018/1H 2019) AD Agitation ADVANCE-1 interim analysis (2H 2018) ADVANCE-1 interim efficacy analysis ADVANCE-1 top-line results (2H 2019/1H 2020) Smoking Cessation Ph 2 trial initiated Ph 2 top-line results AXS-09 (DM + S-BUP) CNS Disorders Ph 1 trial results AXS-07 (MoSEIC Mx + Riz) Migraine Ph 3 trial start Ph 3 top-line results AXS-02 (DZT) Knee OA COAST-1 interim analysis Abbreviations: AD = Alzheimer s Disease; BUP = Bupropion; CLBP = Chronic Low Back Pain; DM = Dextromethorphan; DZT = Disodium Zoledronate Tetrahydrate; Eso = Esomeprazole; ; Mx = Meloxicam; OA = Osteoarthritis; RA = Rheumatoid Arthritis; Riz = Rizatriptan; S-BUP = Esbupropion; TRD = Treatment Resistant Depression. Accomplished milestone. Upcoming milestone. 12

For more information, please contact Mark Jacobson SVP, Operations 212-332-3243 mjacobson@axsome.com axsome.com