Precision Psychiatry 101: Innovation

Alto Neuroscience
March 2, 2023

Precision Psychiatry 101 is a four-part series highlighting pillars of Alto’s approach to psychiatric drug development that matches the right patient with the right drug.

The future of CNS medications requires questioning the status quo and upending existing assumptions through every stage of the drug development process, from discovery to research and clinical applications. Alto Neuroscience is working to revolutionize this process in mental health by pioneering a novel approach referred to as “precision psychiatry.”

Rather than healthcare providers relying on trial-and-error, effectively guessing which drug might work best for a patient based on a blanket diagnosis, precision psychiatry will enable matching patients to the best treatment based on their individual brain biology.  

Dr. Amit Etkin, Alto’s founder and CEO, explains, “Psychiatry has experienced a dearth of innovation over decades driven by a lack in understanding of the underlying biology of patients, reliance on subjective patient assessments, and challenges with clinical trial design and execution.”

Precision psychiatry aims to match patients with the treatment they are most likely to respond to by measuring behavioral patterns, genetics, wearable data, and other factors. Dr Etkin continued:

“Successfully realizing the potential of a precision psychiatry approach would mean that, for the first time, people struggling with mental health conditions might finally be able to find the right drug for them quickly.”

Can data-driven approaches optimize drug development?

Mental health disorders are complex and often not well understood, making it difficult to create new treatments and approaches.

Until now, drug development efforts in psychiatry have proceeded with the assumption that patients respond to the same drug in the same way. However, people with the same mental health diagnosis often respond to a given drug differently because of differences in their underlying biology.

Since inception, a guiding question of Alto’s work has been, “What if the drugs work, but we haven't known who they work for?”

One of the core tenets to the development of Alto’s pipeline was the understanding that biotechnology and pharmaceutical companies perhaps have discovered useful candidates for manipulating different brain systems to date, they just didn’t have the tools to develop these for the right people. 

By licensing or acquiring assets with strong existing safety and tolerability data in humans, and some with clear signals of relevant therapeutic activity, Alto is now supporting high-cadence clinical trials to answer the important follow-on question of, “For whom is a particular drug the right answer?”

Another important question the Alto team has considered as they’ve worked to optimize traditional CNS drug development is, “What if the noise, or differences between patients and their responses, is actually the signal?”

By using this as a starting place for finding novel candidates and identifying likely responders, Alto has been able to build their Precision Psychiatry Platform™ and drug pipeline – consisting of first- or best-in-class drugs. 

How is Alto bringing precision to psychiatry?

Conducting clinical trials for mental health treatments is challenging due to the complexities of CNS disorders and the difficulty in measuring outcomes. Dr. Ektin echoes this sentiment by noting, “We use trial-and-error in the clinic because of an error in the trials themselves.” 

In an effort to remove subjectivity from diagnosis and treatment, Alto’s data-driven approach incorporates non-invasive brain measures to consider a patient’s underlying biology.

While a psychiatric drug has never been developed for people with particular brain measures, or biomarkers, that cannot be otherwise clinically distinguished, Alto’s positive Phase 2 data in major depressive disorder is the first early indicator this novel approach could work.  

Rethinking everything

At Alto, the founding value of Rethink Everything drives the team’s inspiration, core beliefs, and a creative approach to innovation. Alto understands that real innovation for patients requires going beyond the status quo, so the team is committed to thinking differently to do differently. 

Dr. Etkin concluded, “By viewing the problems we’ve faced in developing new treatments in a different way, we’ve been able to drive forward novel drugs and tests to identify the right type of patient for a particular drug.” 

While the use of precision in psychiatry is promising for the development of new therapies, there is still much work to be done to improve the field’s understanding of mental health conditions to develop more effective treatments for patients.

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