What Do Analysts Think About the Biopharma Set on Transforming Psychiatry
Analyst Consensus Report

1. As of the date of this article, officers and/or employees of Streetwise Reports LLC (including members of their household) own securities of Alto Neuroscience Inc.
2. Steve Sobek wrote this article for Streetwise Reports LLC and provides services to Streetwise Reports as an employee.
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4. This article does not constitute medical advice. Officers, employees and contributors to Streetwise Reports are not licensed medical professionals. Readers should always contact their healthcare professionals for medical advice.

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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 William Blair and Alto Neuroscience, March 19, 2026:

IMPORTANT DISCLOSURES William Blair or an affiliate is a market maker in the security of Alto Neuroscience, Inc. William Blair or an affiliate expects to receive or intends to seek compensation for investment banking services from Alto Neuroscience, Inc. or an affiliate within the next three months. William Blair or an affiliate received compensation for investment banking services or non-investment-banking services from Alto Neuroscience, Inc. within the last 12 months. Alto Neuroscience, Inc. is or was, within the last 12 months, an investment banking client of William Blair & Company and/or one or more of its affiliates. Officers and employees of William Blair or its affiliates (other than research analysts) may have a financial interest in the securities of Alto Neuroscience, Inc. This report is available in electronic form to registered users via R*Docs™ at https://williamblairlibrary.bluematrix.com or www.williamblair.com. Please contact us at +1 312 236 1600 or consult https://www.williamblair.com/equity-research/coverage for all disclosures. Myles R. Minter attests that 1) all of the views expressed in this research report accurately reflect his/her personal views about any and all of the securities and companies covered by this report, and 2) no part of his/her compensation was, is, or will be related, directly or indirectly, to the specific recommendations or views expressed by him/her in this report. We seek to update our research as appropriate. Other than certain periodical industry reports, the majority of reports are published at irregular intervals as deemed appropriate by the research analyst.

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Disclosures for H.C. Wainwright & Co. and Alto Neuroscience, March 18, 2026:

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The research analyst principally responsible for preparation of the report does not receive compensation that is based upon any specific investment banking services or transaction but is compensated based on factors including total revenue and profitability of the Firm, a substantial portion of which is derived from investment banking services. The firm or its affiliates received compensation from Alto Neuroscience, Inc. for non-investment banking services in the previous 12 months. The Firm or its affiliates did not receive compensation from Alto Neuroscience, Inc. for investment banking services within twelve months before, but will seek compensation from the companies mentioned in this report for investment banking services within three months following publication of the research report. The Firm does not make a market in Alto Neuroscience, Inc. as of the date of this research report. The securities of the company discussed in this report may be unsuitable for investors depending on their specific investment objectives and financial position. Past performance is no guarantee of future results. This report is offered for informational purposes only, and does not constitute an offer or solicitation to buy or sell any securities discussed herein in any jurisdiction where such would be prohibited. This research report is not intended to provide tax advice or to be used to provide tax advice to any person. Electronic versions of H.C. Wainwright & Co., LLC research reports are made available to all clients simultaneously. No part of this report may be reproduced in any form without the expressed permission of H.C. Wainwright & Co., LLC. Additional information available upon request.

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Disclosures for Stifel and Alto Neuroscience, March 17, 2026:

I, Paul Matteis, research analyst, certify that the views expressed in this research report accurately reflect my personal views about the subject securities or issuers; and I, Paul Matteis, certify that no part of my compensation was, is, or will be directly or indirectly related to the specific recommendations or views contained in this research report. Our European Policy for Managing Research Conflicts of Interest is available at www.stifel.com/institutional/ImportantDisclosures. The disclosures contained in this report are applicable as of the date of publication. For a current price chart with historical rating and target price changes as well as current disclosures for ANRO go to http://stifel2.bluematrix.com/sellside/Disclosures.action?ticker=ANRO Alto Neuroscience, Inc. is a client of Stifel or an affiliate or was a client of Stifel or an affiliate within the past 12 months. Alto Neuroscience, Inc. is provided with investment banking services by Stifel or an affiliate or was provided with investment banking services by Stifel or an affiliate within the past 12 months. Stifel or an affiliate has received compensation for investment banking services from Alto Neuroscience, Inc. in the past 12 months. Stifel or an affiliate expects to receive or intends to seek compensation for investment banking services from Alto Neuroscience, Inc. in the next 3 months. Stifel or an affiliate is a market maker or liquidity provider in the securities of Alto Neuroscience, Inc. The equity research analyst(s) responsible for the preparation of this report receive(s) compensation based on various factors, including Stifel's overall revenue, which includes investment banking revenue.

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Disclosures for Jefferies and Alto Neuroscience, March 16, 2026:

Analyst Certification: I, Andrew Tsai, certify that all of the views expressed in this research report accurately reflect my personal views about the subject security(ies) and subject company(ies). I also certify that no part of my compensation was, is, or will be, directly or indirectly, related to the specific recommendations or views expressed in this research report. I, Matthew Barcus, Ph.D., certify that all of the views expressed in this research report accurately reflect my personal views about the subject security(ies) and subject company(ies). I also certify that no part of my compensation was, is, or will be, directly or indirectly, related to the specific recommendations or views expressed in this research report. I, John Cox, Ph.D., certify that all of the views expressed in this research report accurately reflect my personal views about the subject security(ies) and subject company(ies). I also certify that no part of my compensation was, is, or will be, directly or indirectly, related to the specific recommendations or views expressed in this research report. I, Brian Balchin, ACA, certify that all of the views expressed in this research report accurately reflect my personal views about the subject security(ies) and subject company(ies). I also certify that no part of my compensation was, is, or will be, directly or indirectly, related to the specific recommendations or views expressed in this research report. As is the case with all Jefferies employees, the analyst(s) responsible for the coverage of the financial instruments discussed in this report receives compensation based in part on the overall performance of the firm, including investment banking income. We seek to update our research as appropriate, but various regulations may prevent us from doing so. Aside from certain industry reports published on a periodic basis, the large majority of reports are published at irregular intervals as appropriate in the analyst's judgement. Investment Recommendation Record (Article 3(1)e and Article 7 of MAR) Recommendation Published Recommendation Distributed March 16, 2026 10:41 A.M. March 16, 2026 10:41 A.M. Company Specific Disclosures Jefferies Financial Group Inc., its affiliates or subsidiaries expect to receive or intend to seek compensation for investment banking services from Alto Neuroscience, Inc. within the next three months. Within the past 12 months, Jefferies Financial Group Inc., its affiliates or subsidiaries has received compensation from investment banking services from Alto Neuroscience, Inc.. Within the past twelve months, Alto Neuroscience, Inc. has been a client of Jefferies Financial Group Inc., its affiliates or subsidiaries and investment banking services are being or have been provided. Jefferies Financial Group Inc., its affiliates or subsidiaries has acted as a manager or co-manager in the underwriting or placement of securities for Alto Neuroscience, Inc. or one of its affiliates within the past twelve months.

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 / Outperform / Hold

Target: US $35.17 / CA $48.53

How Avg Analyst Ratings Are Calculated

04/01/2026

Dr. Laura Chico – Wedbush

Price at Time of Rating: US $23.41 / CA $32.31

Rating: Hold

Target Price: US $21.00 / CA $28.98

04/01/2026

Dr. Thomas Shrader – BTIG Research

Price at Time of Rating: US $23.41 / CA $32.31

Rating: Buy

Target Price: US $28.00 / CA $38.64

04/01/2026

Keay Nakae – Chardan Capital Markets

Price at Time of Rating: US $23.41 / CA $32.31

Rating: Buy

Target Price: US $30.00 / CA $41.40

04/01/2026

Justin Walsh – JonesTrading

Price at Time of Rating: US $23.41 / CA $32.31

Rating: Buy

Target Price: US $44.00 / CA $60.72

03/19/2026

Dr. Myles Minter – William Blair

Price at Time of Rating: US $22.52 / CA $31.08

Rating: Outperform

Target Price: US $40.35 / CA $55.68

03/18/2026

Patrick Trucchio – H.C. Wainwright & Co.

Price at Time of Rating: US $22.45 / CA $30.98

Rating: Buy

Target Price: US $50.00 / CA $69.00

03/17/2026

Paul Matteis – Stifel

Price at Time of Rating: US $22.36 / CA $30.86

Rating: Buy

Target Price: US $33.00 / CA $45.54

03/16/2026

Andrew Tsai – Jefferies & Co.

Price at Time of Rating: US $22.26 / CA $30.72

Rating: Buy

Target Price: US $35.00 / CA $48.30

Alto Neuroscience Inc. (ANRO:NYSE) is a clinical-stage biopharmaceutical company focused on transforming psychiatry through novel drug candidates for a range of mental health conditions including bipolar depression, major depressive disorder, treatment-resistant depression, and schizophrenia.

The company's Precision Psychiatry Platform utilizes neurobiology, analyzing EEG activity, neurocognitive assessments, wearable data, and other factors to identify patients likely to respond to its treatments.

Alto describes itself as ". . . on a mission to redefine psychiatry by leveraging neurobiology to develop personalized and highly effective treatment options. The company is headquartered in California.

¹From the following analysts' ratings, Street Smart came up with an average rating of Buy/Outperform/Hold, with an average target price of US$35.17/CA$48.53.

Myles Minter — William Blair

Alto's ALTO-207 is capturing attention, particularly due to encouraging results from the PAX-D clinical trial for treatment-resistant depression (TRD) and its notable efficacy on anhedonia as shown in the PRIME-PRAXOL study, according to a research note by Myles Minter for William Blair on March 19.

Following a substantial US$120 million PIPE in March, the company has secured funding for ALTO-207 through critical studies up to a potential NDA submission, effectively eliminating any financial uncertainties.

In the competitive landscape, Johnson & Johnson’s Spravato, a branded therapy for TRD, has set a high industry standard, reporting US$1.7 billion in revenue in 2025, a 57% increase from the previous year, with projected peak sales of about US$3.5 billion. Despite some safety concerns, it remains a leading treatment. ALTO-207, however, stands out with its unique mechanism and oral pill formulation that poses no dissociative risks or REMS requirements, positioning it distinctively in the TRD market, the analyst wrote.

Clinical studies have shown ALTO-207, particularly in combination with pramipexole, to produce significant treatment effects, surpassing those seen with psychedelics, which have demonstrated more modest outcomes when actual unblinding is considered. This efficacy is supported by recent meta-analyses and studies that have documented the shortcomings of psychedelic treatments.

Looking ahead, Alto is poised to release top-line data from the Phase II proof-of-concept study of ALTO-101, targeting cognitive impairment associated with schizophrenia, and from a Phase IIb study of ALTO-300 as an adjunct treatment for major depressive disorder (MDD) in mid-2026, Minter said. These updates are eagerly anticipated by investors as key indicators of the company's ongoing progress.

The company's robust pipeline and solid financial standing are expected to potentially lead to significant clinical successes and substantial price appreciation, the note reported.

New developments include the upcoming Phase IIb trial of ALTO-207 in TRD, set to begin in the first half of 2026. This placebo-controlled study will involve approximately 178 TRD patients who have not responded adequately to previous treatments. The trial will include a dose titration period aiming for a daily dose of 3.2 mg pramipexole/15 mg ondansetron.

Additionally, in January 2026, Alto expanded its intellectual property with a new method-of-treatment patent for ALTO-207, enhancing its market position. The company's strategic use of funding from the recent PIPE financing is directed towards advancing ALTO-207 through Phase III studies and towards NDA submission, ensuring continued development and testing of this promising therapeutic option.

Alto Neuroscience has recently unveiled details about the upcoming Phase IIb trial for ALTO-207, set to begin in the first half of 2026. This crucial trial will involve approximately 178 patients suffering from treatment-resistant depression (TRD) and will assess ALTO-207 as an adjunctive treatment in a parallel-group, placebo-controlled setting. Participants, who will have experienced between two to five prior treatment failures and have a MADRS score of 25 or higher, will continue on their baseline antidepressant medications throughout the trial. The 8-week treatment period will include a dose titration of ALTO-207 to a target daily dose of 3.2 mg pramipexole/15 mg ondansetron.

In financial developments, Alto has secured significant funding through a March PIPE financing, raising US$120 million. These funds are earmarked for advancing ALTO-207 through the necessary Phase IIb and III studies and towards a potential NDA submission, ensuring the project is well-capitalized through crucial stages of development.

Furthermore, Alto has broadened its intellectual property portfolio with the issuance of a new method-of-treatment patent for ALTO-207 in January 2026. This expansion is part of Alto's broader strategy to solidify its standing in the neuropsychiatry drug development arena.

Despite the setback from the failure of ALTO-100, Alto remains committed to its Precision Psychiatry Platform. The company does not view this single failure as indicative of the overall strategy’s invalidity. Looking ahead, Alto is focused on the forthcoming results from ALTO-300 in MDD, which utilizes EEG-based biomarkers identified by Alto Scope in conjunction with the commercially approved antidepressant, agomelatine. Notably, ALTO-207’s development does not rely on biomarkers, but it benefits from the inherent dopamine dysregulation in TRD patients, as underscored by promising results from the PAX-D trial.

According to Minter, Alto’s strategic positioning within the neuropsychiatry sector, combined with its innovative approach and robust funding, presents an attractive risk/reward profile for investors. He rated the company’s shares as Outperform, with a revised probability-adjusted net present value (NPV) fair value of US$40.35 per share, a 79% return from the price at time of writing, reflecting confidence in its potential to navigate the complexities of drug development and achieve significant clinical and commercial success.

Patrick Trucchio — H.C. Wainwright & Co.

Alto Neuroscience is poised for a dynamic 2026, filled with several crucial data releases, according to a March 18 research note by H.C. Wainwright & Co. Analyst Patrick Trucchio.

The company announced its fourth-quarter results for 2025 on March 16, highlighting substantial financial, clinical, and regulatory progress in its advanced-stage programs. Notably, as of December 31, Alto had a cash reserve of US$177 million, anticipated to support operations until 2028 and cover various significant data readouts, he said. These include top-line results from three key trials: the Phase 2 proof of concept (POC) trial for ALTO-101 targeting cognitive impairment associated with schizophrenia (CIAS) expected around the first quarter of 2026, the Phase 2b trial for ALTO-300 in major depressive disorder (MDD) anticipated by mid-2026, and the Phase 2b trial for ALTO-100 in bipolar depression (BPD) expected in the second half of 2026.

Additionally, on March 16, Alto secured an extra US$120 million through private placement financing. This funding is earmarked for advancing ALTO-207 in treatment-resistant depression (TRD) through a Phase 3 trial slated to begin in early 2027, potentially leading to a new drug application (NDA) submission, with projected pro forma cash reaching approximately US$275 million, the analyst noted.

Earlier in the year, on January 13, Alto presented new analyses from an independent data set that reinforced previous findings, supporting Theta-ITC as a robust electroencephalography (EEG) marker for detecting differences in schizophrenia cases. This analysis helps de-risk the forthcoming ALTO-101 POC data, according to the note.

Viewing the broader picture, precision neuropsychiatry is seen as a viable solution to the structural limitations currently faced in psychiatric treatment. Alto's innovative programs are strategically positioned to transform the treatment landscape.

Financially, Alto is well-prepared for these upcoming trials, having secured the US$120 million through a private placement financing. This funding is expected to cover the costs of the Phase 3 trial and any subsequent steps towards a New Drug Application (NDA) submission, should the trials prove successful.

Additionally, Alto has recently enhanced its intellectual property stance, with new patent claims issued that could extend into the mid-2040s, further solidifying its market position, the report said.

From an investment perspective, Alto Neuroscience presents a compelling opportunity. The company's shares are valued at US$25 each, based on a sum-of-the-parts (SOTP) and risk-adjusted discounted cash flow (DCF) analysis. This valuation considers the probabilities of success for its various programs: 30% for both ALTO-300 in major depressive disorder (MDD) and ALTO-207 in TRD, and 10% for ALTO-100 in bipolar depression (BPD). Planned annual equity raises of $150 million from 2027 to 2029 are expected to support clinical development and potential commercial launch expenses, though they may dilute current shareholders.

Employing a 12% discount rate and a 6x terminal multiple, and factoring in the value of the underlying biomarker platform and net cash, the total firm value is estimated at approximately US$2 billion, supporting a US$50 price target, a 99% return from the time of writing. This valuation underscores Alto's potential as a first-in-class oral therapy for TRD with blockbuster prospects, should the pivotal data replicate earlier phase signals.

Paul Matteis — Stifel

According to an updated research note on March 17, Stifel Analyst Paul Matteis noted the firm maintained a Buy rating on ANRO following its fourth-quarter 2025 earnings, which aligned with expectations. His target price is US$33 per share, a 48% return from the price at the time the note was written.

A critical highlight for ANRO is its progression with the ALTO-207 (pramiprexole+ondansetron) treatment for treatment-resistant depression (TRD), set to commence a Phase 2b trial in the first half of 2026. ALTO-207 stands out as ANRO's most promising asset, bolstered by strong data supporting pramipexole's effectiveness in treating depression and successful precedents set by dual-drug combinations in neuropsychiatry, such as Auvelity and KarXT. The accelerated development timeline anticipates a Phase 3 trial beginning in early 2027.

Additionally, ALTO-300, which utilizes agomelatine, is on track to deliver Phase 2b results for major depressive disorder (MDD) by mid-2026, Matteis wrote. The established efficacy of agomelatine positions ANRO for potential success in this trial. Moreover, top-line data from the ALTO-101 study in cognitive impairment associated with schizophrenia (CIAS) are expected by the end of the first quarter of 2026. This study is a biomarker-based trial with relatively modest expectations.

A significant financial development for ANRO was the announcement of a PIPE financing, which extends the company’s cash runway. This financing is crucial as it supports the continued development of ALTO-207 through its upcoming Phase 3 trial and potential New Drug Application (NDA) submission.

ALTO-207's Phase 2b trial is designed as a placebo-controlled, adjunctive study with about 178 TRD patients, assessing changes in the Montgomery Åsberg Depression Rating Scale (MADRS) over eight weeks, with results anticipated in the second half of 2027. ANRO has also secured a new method-of-treatment patent, bolstering its intellectual property portfolio into the mid-2040s.

For ALTO-300, the ongoing Phase 2b trial leverages an EEG biomarker signature to identify likely responders, enhancing the trial's design based on interim analysis findings. This trial is expected to report in mid-2026 with a cohort of 200 biomarker-positive patients, the note said.

The broader pipeline includes ALTO-101, with top-line data expected soon, and ALTO-100's Phase 2b trial in bipolar depression (BPD) slated for the second half of 2026. Each asset presents a favorable risk-reward scenario, particularly ALTO-207, which significantly influences the company's valuation.

Following the earnings announcement, ANRO also disclosed a substantial PIPE financing of approximately US$120 million, earmarked to support ALTO-207 through its Phase 3 trial and towards an NDA. This financing boosts ANRO’s projected cash reserves to approximately US$275 million as of the end of February, ensuring robust financial footing for upcoming clinical milestones.

Andrew Tsai — Jefferies

ANRO's precision psychiatry platform is set to deliver multiple critical data readouts throughout 2026 and 2027, according to a research report by Analyst Andrew Tsai for Jefferies on March 16.

At the end of the first quarter of 2026, ALTO-101, which is a PDE4 patch, is expected to provide Phase II data for cognitive impairment associated with schizophrenia (CIAS). This data may reveal a significant correlation between EEG, serving as an efficacy biomarker, and cognitive functions, the analyst said.

By mid-2026, ALTO-300, an oral formulation of agomelatine, will yield Phase IIb data for major depressive disorder (MDD). In the second half of 2026, ALTO-100, an oral BDNF treatment, is anticipated to produce Phase IIb data for bipolar depression (BPD).

Lastly, in the second half of 2027, ALTO-207, an oral dopamine combination therapy, is scheduled to release Phase IIb data as an adjunct treatment for treatment-resistant depression (TRD), Tsai said.

ANRO is gearing up for a significant year with multiple critical trials scheduled, the note continued. For its ALTO-207 treatment, a combination of pramipexole and ondansetron designed for treatment-resistant depression (TRD), a pivotal 8-week Phase IIb trial is set to commence in the first half of 2026, with results expected in the latter half of 2027. This will be followed by the initiation of a Phase III trial in early 2027, with data anticipated in 2028. ANRO acquired ALTO-207 from Chase Tx in June 2025 for less than $2 million, leveraging the combination to mitigate gastrointestinal side effects like nausea and vomiting associated with pramipexole. The upcoming Phase IIb trial will involve 178 TRD patients who have experienced 2 to 5 prior treatment failures and will assess the efficacy of ALTO-207, with the primary endpoint being the change from baseline in the Montgomery Åsberg Depression Rating Scale (MADRS).

To optimize safety and tolerability, the trial will include a titration period extending pramipexole to 3.2mg daily over 13 days, a pace slower than previous trials, according to the analyst. This approach aims to maintain adverse effects at minimal levels above placebo. The trial is designed to detect an effect size of d=0.30-0.35, building on previous positive outcomes from Phase IIa trials and a 48-week PAX-D UK study that demonstrated significant improvements in TRD symptoms.

Separately, ANRO is preparing to initiate a Phase I dose-ranging study for ondansetron and a 13-week bridging toxicology study to facilitate the later stages of the Phase IIb and III trials. These studies are part of ANRO’s broader strategy to potentially secure a comprehensive TRD label for ALTO-207, while also exploring biomarkers to enhance treatment efficacy.

Additionally, ALTO-101, a PDE4 patch targeting cognitive impairment associated with schizophrenia (CIAS), is expected to deliver Phase II data by the end of the first quarter of 2026. This trial involves a crossover design where patients receive either ALTO-101 or a placebo for 10 days, followed by a washout and then the alternate treatment. The study aims to demonstrate significant effects on theta EEG and potentially cognition, providing further insights into the treatment’s impact on schizophrenia-related cognitive impairments.

Tsai rated the stock Buy with a US$35 per share price target, a 57% return at the time of writing.

More Analyst Ratings

Other analysts with ratings on the stock include Wedbush Securities' Laura Chico, with a hold Hold recommendation with a US$21 target price; TD Cowen's Ritu Baral with a Buy recommendation and no price target; BTIG's Thomas Shrader with a Buy recommendation and a US$28 target price; Chardan's Keay Nakae with a Buy recommendation and a US$30 target price; and JonesTrading's Justin Walsh with a Buy recommendation and a U$44 target price, Factset reported.

Ownership and Share Structure²

Alto Neuroscience Inc. has a market cap of US$693.54 million, with 31.95 million shares outstanding.

The company has a 52-week range of US$1.90-US$25.17.

Management and insiders own 6.25% of shares, while institutions own 76.87%. The remaining shares are retail.