How Do Analysts Rate This Biopharma Targeting Psychiatric Disorders
Analyst Consensus Report

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1. Street Smart Average Price Target Formula

   Street Smart Consulting has attained an average price target and rating for this company from our system's formula. The system calculates an average of all analyst target prices, which are originally in Canadian or U.S. dollars, then converts them to both dollar amounts. For the recommendation, it selects whichever rating (Buy, Sell, Hold, etc.) appears most frequently among analysts. When there's a tie for the most common recommendation, all tied ratings are included.

2. Ownership and Share Structure Information

   The information listed above was updated on the date this article was published and was compiled from information from the company and various other data providers.

Disclosures for BTIG, Alto Neuroscience, November 17, 2025:

Analyst Certification: I, Thomas Shrader, hereby certify that the views about the companies and securities discussed in this report are accurately expressed and that I have not received and will not receive direct or indirect compensation in exchange for expressing specific recommendations or views in this report. I, Jinnie Kim, hereby certify that the views about the companies and securities discussed in this report are accurately expressed and that I have not received and will not receive direct or indirect compensation in exchange for expressing specific recommendations or views in this report.

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StreetSmart Research™

Alto Neuroscience Inc.

(ANRO:NYSE)

Consensus Average Rating & Price Target

Price targets are based on the original currency and converted to US and/or CA using current exchange rates at the time of publication.

Rating: Buy

Target: US $26.00 / CA $35.88

How Avg Analyst Ratings Are Calculated

11/17/2025

Andrew Tsai – Jefferies & Co.

Price at Time of Rating: US $13.80 / CA $19.04

Rating: Buy

Target Price: US $25.00 / CA $34.50

11/17/2025

Dr. Thomas Shrader – BTIG Research

Price at Time of Rating: US $11.35 / CA $15.66

Rating: Buy

Target Price: US $27.00 / CA $37.26

Alto Neuroscience Inc. (ANRO:NYSE) provided an update on its investigational drug pipeline and reported its Q3/25 financial results, as noted in a news release.

This California-based company is developing drug candidates for psychiatric and neurological disorders, utilizing a precision approach rather than a one-size-fits-all method. In other words, the firm is leveraging patients' unique neurobiology to create personalized, highly effective treatment options.

In recent developments, the company completed a private investment in public equity (PIPE), raising gross proceeds of US$50 million. This increased Alto's cash reserves to US$184.2 million as of October 31, an amount sufficient to support planned operations through 2028. At the end of Q3/25, the biopharmaceutical company had US$138.3 million in cash, cash equivalents, and restricted cash, compared to US$168.7 million a year earlier.

Regarding its other Q3/25 financial results, Alto reported a net loss of US$14.2 million, an improvement over the US$16.8 million net loss from the previous year. Both research and development (R&D) expenses and general and administrative (G&A) expenses were lower in Q3/25 than in Q3/24, at US$10.5 million versus US$13.1 million and US$4.4 million compared to US$5.8 million, respectively.

¹From the following analysts' ratings, Street Smart came up with an average rating of Buy, with an average target price of US$26/CA$35.88.

Thomas Shrader — BTIG

According to a research note by Analyst Thomas Shrader for BTIG on November 17, Alto Neuroscience is a biotechnology company in the development phase, concentrating on next-generation psychiatric drugs, including those for MDD and TRD.

Each program is backed by innovative biomarkers to identify patient subgroups most likely to respond to the drug's specific mechanism. Alto selects biomarkers with an emphasis on "real-world" applicability that can be routinely used outside academic settings. Additionally, the company casts a wide net to discover potential biomarkers but then works to validate that these biomarkers are genuinely predictive of clinical outcomes and not merely correlative in a single dataset, according to Shrader.

This precision approach is expected to increase the likelihood of clinical success during development and result in a more compelling final label for successful drugs, the report said. The company also places significant emphasis on clinical trial conduct to control site-level inconsistencies, such as incorrect diagnoses and poor drug compliance.

"We see this combined model of finding patients likely to have the largest treatment effects and running trials with the lowest chance for noise as the frontier of the field," Shrader wrote. "Other companies are involved in similar approaches, but precision neuroscience is at the core of Alto. The story is rich in meaningful catalysts with four major readouts over the next two years including three P2b trials that each could be meaningful inflection points for the stock."

Shrader rated the stock a Buy with a US$27 per share target price, a 138% increase from the time of writing.

Interest in Alto has increased since acquiring ALTO-207, a combination containing the serotonin D3 > D2 receptor agonist Pramipexole, which is approved for PD and has shown substantial treatment effects in depression (about three times the size of many approved drugs), Shrader said. ALTO-207 includes ondansetron to reduce adverse effects of D3 stimulation, such as nausea.

"The approach, as validated by COBENIFY, makes sense to us as the combination can now be titrated to effective doses 5x faster and to higher levels to produce greatly improved safety, while retaining the compelling treatment effects," Shrader noted.

A P2b trial is expected to start in mid-2026, with a P3 trial in 2027, and this pair of trials is designed to support approval (the FDA has endorsed the design), the research report said. Trials are expected to be enriched based on a biomarker for low dopamine in TRD patients, where dopamine levels are generally low. The stock has appreciated since the ALTO-207 acquisition but has not fully captured the large treatment effect's value, and the other programs seem to be ascribed little value.

The other lead program involves enhancing an approved drug. ALTO-300 combines melatonin receptor stimulation with established 5-HT2C agonism (triggering dopamine release). The idea is to improve dopamine activity—a key deficiency in MDD and TRD patients that drives anhedonia—while also resynchronizing the circadian rhythms of depressed patients, Shrader wrote. The drug is approved in the EU as agomelatine and has a uniquely benign safety profile, prompting Alto to develop the drug in the MDD adjunctive setting. Patients are selected based on a validated biomarker of dopamine activity to further increase the treatment effect. The next P2b readout in MY26 is the biggest near-term catalyst for the stock.

ALTO-101 is a PDE4 inhibitor designed to enhance correctly regulated neural signaling in the CNS, the note said. The next readout is in 1Q26 and will provide insights into improved cognition with the goal of helping schizophrenic patients (CIAS indication). ALTO-100 is a neural plasticity stimulator that could be applicable throughout psychiatry if active. The lead indication is bipolar depression. This readout follows a failed MDD trial but also after Alto has made modifications to improve the clinical trial conduct at chosen sites.

"We see this Alto model of identifying patients likely to have the largest treatment effects and running trials with the lowest chance for noise as the frontier of the field," Shrader wrote. "The lead programs ALTO-207 and ALTO-300 both looked risk-reduced as they are optimizations of approved drugs with attractive properties. Readouts in the next 18 months have the potential to both increase interest in the lead drugs and validate the precision psychiatry model."

Andrew Tsai — Jefferies

An intriguing lineup of catalysts for 2026-27 could propel Alto Neuroscience's stock upward, boosting investor confidence in ANRO's precision psychiatry approach, according to a November 17 research report on the company by Jefferies Analyst Andrew Tsai.

The firm rated the stock a Buy with a US25 per share price target, a return of 81% at the time of writing.

Since acquiring ALTO-207 (oral dopamine combo) for less than US$2 million upfront in June 2025, ANRO has accelerated development timelines for TRD depression. Management plans to initiate a Phase IIb in the first half of 2026 (with data in 2027) and a Phase III in Q1 2027 (with data in 2028), Tsai wrote.

ALTO-207 is a fixed-dose combination of pramipexole (dopamine D2/D3) and ondansetron (antiemetic), with the latter intended to mitigate GI side effects caused by pramipexole. ANRO is finalizing CMC stability work before starting the Phase IIb in the first half of 2026.

The eight-week Phase IIb will randomize patients 1:1 to ALTO-207 or placebo, the report said. Patients will titrate pramipexole to a target dose higher than previously tested. In ALTO-207's Phase IIa, patients titrated up to an average dose of 4.1mg/d in eight days.

The Phase III will evaluate a lower-dose cohort to establish the minimum effective dose. With potentially pivotal Phase IIb data available in 2027, ANRO will begin the Phase III by early 2027 "at-risk."

Management aims for a greater than 2+ point placebo-adjusted MADRS change, which would be significant in TRD given ALTO-207's oral convenience over Spravato (which requires inpatient dosing) and improved safety over SSRIs/antipsychotics, Tsai said.

ANRO will not use a patient-selection biomarker strategy for ALTO-207 because TRD patients are already hypodopaminergic-enriched, but biomarkers will complement the analysis, the report noted.

Meanwhile, a growing body of evidence supports pramipexole's efficacy in depression, including studies in TRD, MDD, and mood disorders with anhedonia.

For ALTO-101 (PDE4 patch), management is confident in CIAS schizophrenia data in Q1 2026 following positive early biomarker signals.

The Phase II (N=60-70) is a two-way crossover, placebo-controlled study: Period 1 - Patients receive ALTO-101 or placebo (QD) for 10 days, followed by a six-to-14-day washout. Patients are then crossed over to receive placebo or ALTO-101 for 10 days, the analyst said. The primary endpoint is theta band activity (an EEG-based measure of PD activity) after 5 and 10 days of dosing (vs placebo) over both treatment periods (each patient is their own control).

ALTO-101 will advance into Phase IIb if theta ITC moves significantly. The ongoing Phase II study's short 10-day dosing may not be enough to show cognition benefits but could present an upside scenario, according to Tsai.

Management's confidence is partly based on a September 2025 replication of EEG biomarker data, which showed theta ITC yielding a Cohen’s d=0.64 (p<0.001) between CIAS patients and healthy controls — superior to traditional EEG biomarkers. Theta ITC also showed a statistically significant correlation with processing speed, a core feature of CIAS (p<0.05).

ANRO also has full MDD data for ALTO-300 (oral agomelatine) on N=200 biomarker+ patients in mid-2026.

"In Feb 2025, a supportive interim analysis on N=87+ bio+ patients suggested the study was showing at least a 2+ point MADRS delta (fundamentally approvable)," Tsai wrote in the research note. "The study was upsized to N=200 bio+ pts to mitigate site-level execution risk, following a previous Phase IIb miss with ALTO-100 (oral BDNF) in MDD. The modest upsize powers the study to a Cohen's d=0.40 (vs d=0.45 previously). Separately, ALTO-100 has Phase IIb BPD depression data in H2:26."

Ownership and Share Structure²

Five insiders own 6.44% of Alto, including Founder, President, and Chief Executive Officer Dr. Amit Etkin with 3.88%. Numerous institutions have 65.33%. The Top 3 institutional shareholders are Alpha Wave Global LP with 11.94%, Perceptive Advisors LLC with 6.4% and Commodore Capital LP with 5.32%. Retail investors hold the rest.

Alto has 31.07 million shares outstanding. Its market cap is US$468.48 million. Its 52-week range is US$1.60–20.91 per share.