Brain Man

HERRIOT TABUTEAU combined a Yale medical degree with two decades in finance to start biotech firm AXSOME. Now its success with drugs for neurological disorders has made the Haiti-born immigrant a new billionaire.

- By Amy Feldman

When Herriot Tabuteau started a drug development company in 2012, he decided to do so differently. First, he'd focus on brain disorders, treatments for which are notoriously difficult to develop and whose efficacy can be hard to prove. And he'd be both CEO and the scientific founder, bringing to bear his decades of experience investing in biotech startups and his medical training. But he'd take no venture capital, self-funding with help from friends and family.

"If you do things exactly the same way as everybody else, you're going to have the same outcomes as everybody else. And we wanted to have outcomes that stand apart," Tabuteau, 57, says, during his first-ever interview with a reporter about his company, Axsome Therapeutics.

Named for two parts of a nerve cell, the “axon” and the “soma,” Axsome has come a long way from its beginnings in a windowless three-desk office in New York's Rockefeller Center, affectionately remembered as “the broom closet.” Today, it has three drugs on the market and five in the pipeline, with the potential to help the estimated 150 million Americans suffering from conditions like depression, ADHD or Alzheimer's disease. Revenue for the 12 months ended in June reached $495 million, up 70% from the same period in 2024. Axsome is not yet profitable, booking a net loss of $247 million in that time.

The company trades on the Nasdaq with a market cap of $6.1 billion; Tabuteau is a billionaire thanks to his 15% stake in it, plus options. He figures Axsome could hit $16.5 billion in peak sales from its current drug portfolio, which would put it among the top 25 drug companies by revenue today. That's assuming all goes to plan, most particularly getting five new drugs through the FDA between now and 2028. It's a big ask: Only about 25% of drugs do well enough in Phase III trials to move forward in the FDA process.