Alto closed a $120 million private investment in public equity in March 2026, boosting its cash balance to approximately $264 million as of March 31, 2026. This capital is projected to fund operations, including planned Phase 3 trials and a potential NDA submission for ALTO-207, through 2029.

In April 2026 Alto initiated a randomized, double-blind, placebo-controlled Phase 2b trial of ALTO-207 as an adjunctive treatment in about 178 adults with treatment-resistant depression who experienced two to five prior treatment failures. The trial employs MADRS as the primary endpoint and is designed to replicate the Cohen’s d = 0.87 effect size observed in the PAX-D study.

The U.S. Patent and Trademark Office issued a method-of-treatment patent in January 2026 (No. 12,521,374), protecting the use of ondansetron to mitigate pramipexole-related side effects for higher dosing in depression. Combined with Alto’s broader estate of issued and pending patents, ALTO-207 is expected to have exclusivity through at least the mid-2040s.

Topline results from the Phase 2 proof-of-concept trial of ALTO-101 in cognitive impairment associated with schizophrenia showed a directional improvement in theta-band inter-trial coherence (Cohen’s d = 0.34, p = 0.052) and significant increases in individual alpha peak frequency (d = 0.59, p = 0.001) and high-frequency power (beta d = 0.70, gamma d = 0.61).