Alto Neuroscience, Inc.: management transactions · United States · SEC (Form 4)

About Alto Neuroscience, Inc.

Alto Neuroscience, Inc. is a clinical-stage biopharmaceutical company listed on the U.S. NYSE under the ticker ANRO, and it operates in the United States. Headquartered in Mountain View, California, the company was founded in 2019 by Amit Etkin, M.D., Ph.D., after more than a decade of clinical research at Stanford. Alto’s core investment case is built around a precision-psychiatry strategy that seeks to move psychiatry away from trial-and-error prescribing toward biomarker-driven treatment selection. For investors, this makes Alto a differentiated, high-upside but execution-sensitive small-cap biotech focused on neuropsychiatric disorders. The company’s platform, Precision Psychiatry Platform™, combines EEG-based brain biomarkers, neurocognitive assessments, wearable-derived data, and other biological signals to identify the patients most likely to respond to a given therapy. That approach is intended to improve clinical development efficiency and eventually support more personalized treatment options in a therapeutic area where response rates are often modest and heterogeneous. Alto’s pipeline spans multiple major mental-health indications, including treatment-resistant depression (TRD), major depressive disorder (MDD), bipolar depression, and schizophrenia-related cognitive impairment (CIAS). Its programs are branded ALTO-100, ALTO-101, ALTO-300, and ALTO-207. From a competitive standpoint, Alto is trying to carve out a niche at the intersection of psychiatry, biomarkers, and drug development. That is notable because many CNS companies rely primarily on conventional symptom-based development, whereas Alto is explicitly trying to enrich trials with predictive biology. If successful, this could translate into higher clinical hit rates and clearer differentiation versus broader neuropsychiatry peers. The company’s key assets include ALTO-207, a fixed-dose combination of pramipexole and ondansetron for TRD; ALTO-101 for CIAS; ALTO-300 for MDD; and ALTO-100 for bipolar depression. Recent news has materially improved the visibility of the story. In 2025, Alto acquired ALTO-207 and later accelerated its development following financing activity. In 2026, the company initiated the Phase 2b TRD trial for ALTO-207, reported additional supportive analyses for ALTO-101, and strengthened its balance sheet with a $120 million PIPE in March 2026. As of March 31, 2026, Alto reported approximately $264 million in cash, cash equivalents, and restricted cash, which it said should support planned operations through 2029, including a potential NDA submission for ALTO-207. Overall, Alto Neuroscience remains an innovation-led U.S. psychiatry biotech on the NYSE, with multiple near- and medium-term clinical catalysts that could drive sentiment and valuation.