The Alto Advantage: Operate with Urgency

Interview with Mikael Eliasson, MD, PhD, COO
September 29, 2022
Alto Advantage

The Alto Advantage is a five-part series that covers the company’s guiding principles for pioneering precision psychiatry and, ultimately, establishing a new treatment paradigm in mental health.

For people with mental health conditions, time is of the essence. In the United States alone, over 50 million people live with mental illness yet psychiatric medication only works initially for roughly one in three patients, with traditional paths to treatment based on trial-and-error.

With this in mind, the Alto team is working quickly but thoughtfully to pioneer precision psychiatry and outpace the rapidly evolving mental health crisis. The company is precise yet speedy in both their actions and delivery.

The nature of Alto’s mission lends itself to expediency, which is why Mikael Eliasson, MD, PhD, was motivated to join the team as COO in April of this year.

“I left a great job at Genentech/Roche where I served as global head of innovation in neuroscience product development. I loved the work, but I was seeking to scale transformative innovation more quickly. At Alto, we’re able to do this,” Dr. Eliasson remarked.

“We’re not confined by operating in a certain way according to a set of structural determinants. We’re actively creating our own path each day.”

Run in the Right Direction

Dr. Eliasson has eagerly supported Alto to codify the company’s action steps by defining a clear path forward. Ideas only matter if you execute against them. He noted, “Clear targets that outline what we’re operating against, what we’re trying to achieve, are particularly important when you’re moving quickly as a tech-leaning biotech startup. We need to make sure everyone is moving in the same direction”

“The guidance we provide the team is: ‘Here’s the mountain we're going to climb. Now let’s figure out how we get to the top together,’ Dr. Eliasson continued. “We empower each person to contribute their expertise to help determine which road we should take, the modes of ‘transportation’ we’ll need, et cetera, and are open to all perspectives. This works well because we’ve aligned on what our ultimate goal is. Now, we’re able to rapidly advance towards it.”

The company is working to strike the perfect balance between speed, scale, and sustainability to create near-term value for patients, clinicians, investors, and other key stakeholders.

“Our human-data powered flywheel is at a point where we’re clearly seeing that our biomarker platform enables us to develop novel drugs, and continue to better understand the brain – and it’s all happening at once." 

Eliasson recognizes, “Still, it's not enough to just be busy. We have to be busy on the right things.”

Stay Focused

“Everything we’re doing at Alto is generating some value, but part of my role is to prioritize what will create significant value in the near term,” said Dr. Eliasson. 

Alto is anticipating Phase 2 data readouts from its two lead candidates being studied in depression and PTSD in early 2023.

“We are always very mindful and critical about what we do so as to avoid following the next bright, shiny object that comes along. I see startups fall into this trap, but the one thing I’ve learned in my career is that you are always rewarded and recognized more if you deliver one thing well,” Eliasson commented. 

“I don’t believe in delivering ten things at 60%,” he continued. “The approach we’re taking at Alto is doing a few things really well in the near term to validate our approach, and then the other great outcomes will follow.” 

As Alto remains focused on executing their trials, in addition to data collection and analysis, the company’s north star is to be recognized as the category leader in precision psychiatry. This will be achieved by creating near-term clinical impact and clearly demonstrating that drug development can be de-risked by leveraging their brain-based biomarker platform.

Alto’s Dent in the Universe

Alto is daring to ask the question, “What if the drugs that failed in clinical trials are great drugs but simply weren’t given to the right people?” The company is working to leverage their AI-enabled biomarker platform to predict treatment response in patients and move towards precision in the treatment of mental health disorders.

“We’re thinking both near- and long-term here. One compelling concept that brought me to join Alto was the idea that drugs may have 'failed' in the past because they weren’t studied in the right populations,” Dr. Eliasson said. “With our learnings and brain biomarkers, we have the opportunity to identify a patient's underlying brain biology, and potentially, down the road, completely reclassify neuropsychiatric disorders.”

Can precision psychiatry become a reality in the near-term? Eliasson responded to this question with a resounding, “yes.”

“The primary reason I’m here is that I want to create a lasting impact for mental health and psychiatry. Can we bring precision forward? I believe the answer is ‘yes,’ and I want to be on the team that delivers this,” commented Eliasson. 

“I want to fundamentally change things, and I believe Alto will be the company to make that change happen. That’s what’s motivating me.”


If you are a doctor or clinic interested in learning more about participation in our drug trials, please send us an email at

Interview with Mikael Eliasson, MD, PhD, COO
September 29, 2022
Alto Advantage
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