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J.P. Morgan Healthcare Conference Catherine Owen Adams Chief Executive Officer January 13, 2026 1
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Forward-Looking Statements This presentation contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. Forward-looking statements include all statements other than statements of historical fact and can be identified by terms such as “may,” “will,” “should,” “could,” “would,” “expects,” “plans,” “anticipates,” “believes,” “estimates,” “projects,” “predicts,” “outlook,” “potential,” "milestone," "guidance" and similar expressions (including the negative thereof) intended to identify forward-looking statements. Forward-looking statements contained in this presentation, include, but are not limited to, statements about: (i) our business strategy, objectives and opportunities; (ii) plans for, including timing, development and progress of commercialization or regulatory timelines for our products, including NUPLAZID and DAYBUE, and our product candidates; (iii) benefits to be derived from and efficacy of our products, including the potential advantages ofour products; (iv) the timing and conduct of our clinical trials; (v) estimates regarding the prevalence of the diseases targeted by our products and product candidates; (vi) potential markets for any of our commercial products; and (vii) our estimates regarding our future financial performance, product sales, cash position, profitability, expenses, or capital requirements. Forward-looking statements are subject to known and unknown risks, uncertainties, assumptions and other factors that may cause our actual results, performance or achievements to differ materially and adversely from those anticipated or implied by our forward-looking statements. Such risks, uncertainties and other factors include, but are not limited to: our dependency on the continued successful commercialization of our products and our ability to maintain or increase sales of our products; the costs of our commercialization plans and development programs, and the financial impact or revenues from any commercialization we undertake; our ability to obtain necessary regulatory approvals for our product candidates and, if and when approved, market acceptance of our products; our dependence on third-party collaborators, clinical research organizations, manufacturers, suppliers and distributors; the impact of competitive products and therapies; our ability to generate or obtain the necessary capital to fund our operations; our ability to grow, equip and train our specialized sales forces; our ability to manage the growth and complexity of our organization; our ability to maintain, protect and enhance our intellectual property; our ability to meet our financial guidance; and our ability to continue to stay in compliance with applicable laws and regulations.Given the risks and uncertainties, you should not place undue reliance on these forward-looking statements. For a discussion of these and other risks, uncertainties and other factors that may cause our actual results, performance or achievements to differ, please refer to our annual report on Form 10-K for the year ended December 31, 2024 as well as our subsequent filings with the Securities and Exchange Commission from time to time, including our quarterly reports on Form 10-Q. The forward-looking statements contained herein are made as of the date hereof, and we undertake no obligation to update them after this date, except as required by law. This presentation also contains preliminary and unaudited estimates of the company's 2025 financial performance that are subject to completion of financial closing procedures. Additional information and disclosure would be required for a more complete understanding of the company's financial position and results of operation as of December 31, 2025. In addition, this presentation contains estimates and other statistical data made by independent parties and by us relating to market size and growth and other data about our industry. This data involves a number of assumptions and limitations, and you are cautioned not to give undue weight to such estimates. Projections, assumptions and estimates of the future performance of the markets in which we operate are necessarily subject to a high degree of uncertainty and risk. The trademarks included herein are the property of the owners thereof and are used for reference purposes only. 2
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CORE COMMERCIAL FRANCHISE LATE- STAGE PIPELINE EARLY-STAGE PIPELINE Building Long-Term Growth in Neurological & Rare Diseases BUSINESS DEVELOPMENT EXPANSION AREAS Rett/Fragile X ACP-2591 (cGP analog) Huntington's Disease ACP-271 (GPR88 agonist) SYNGAP1 Stoke ASO (antisense oligonucleotide) Endocrine Metabolic Nephrology Cardiovascular Immunology RARE EARLY-STAGE PIPELINE POWERED BY: Precision medicine | Data innovation | Globalization | Patient empowerment Alzheimer's Disease Psychosis Remlifanserin (5-HT2A inverse agonist) Lewy Body Dementia Psychosis Remlifanserin (5-HT2A inverse agonist) Major Depressive Disorder ACP-211 (Deuterated R-norketamine) Essential Tremor ACP-711 (selective GABAA-α3 modulator) Tardive Dyskinesia ACP-271 (GPR88 agonist) NEUROLOGICAL 3
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Building Momentum Across Our Pipeline Recent Phase 2 or Phase 3 study readouts anticipated by the end of 2027 REFLECTS BREADTH OF PIPELINE AND STRENGTH OF R&D STRATEGY 5 4 Additional Phase 2 or Phase 3 study starts anticipated by the end of 2027 Anticipated Phase 2 Initiation of ACP-211 in Major Depressive Disorder Phase 2 Initiation of remlifanserin (ACP-204) in Lewy Body Dementia Psychosis Phase 3 Initiation of trofinetide in Japan 1Q 26 Initiate first-in-human study of ACP-271 in healthy volunteers 1Q 26 EU CHMP opinion on trofinetide AUGUST - OCTOBER 2026 Top-line results from Phase 2 study of ACP-204 in Alzheimer's Disease Psychosis 8 Disclosed and multiple undisclosed programs 4
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Projected Global Sales for Commercial Products by 2028 NUPLAZID: ~$1B DAYBUE: ~$700M NUPLAZID ~$1.7B Projected FY 2028 Global Net Sales >$1B Anticipated FY 2025 Global Net Sales DAYBUE 5
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Projected Global Peak Sales for Pipeline Programs >$1B Anticipated FY 2025 Global Net Sales ~$1.7B Projected FY 2028 Global Net Sales NUPLAZID: ~$1B DAYBUE:~$700M NUPLAZID DAYBUE ~$11B Full Global Peak Sales Potential (Unadjusted) ~$4B Remlifanserin (ACP-204) peak sales potential for both indications Internal Acadia estimates for full potential peak sales for pipeline molecules as of January 13, 2026, assuming all successfully approved and commercialized. Note: Peak sales used for calculations do not all occur within the same fiscal year. ACP-711 ACP-211 ACP-271 6
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AI-Powered Acceleration Across Acadia COMMERCIAL CLINICAL REGULATORY AI analytics in the field to better target engagement & drive uptake Clinical command center to monitor trials on an ongoing basis, driving quicker decisions Accelerate document development and expand internal capacity 7
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Be Their Difference Everywhere Anticipating CHMP opinion in 1Q26 Initiated Phase 3 clinical trial study in Japan in 4Q25 Approved in Israel ACCESS AND MARKET EXPANSION DAYBUE GLOBAL STRATEGY: NAMED PATIENT SUPPLY PROGRAMS AVAILABLE EU (Clinigen) Middle East (FarmaMondo) Latin America (FarmaMondo) ACADIA DEVELOPMENT PIPELINE: U.S., Brazil, Chile, Bulgaria, Czech Republic, France, Italy, Spain, Japan, Mexico, South Korea, Serbia, Taiwan CURRENT CLINICAL TRIAL SITES 8
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Neurological 9
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~1M patients with Parkinson’s Disease (PD) in the U.S. Around 50% may develop hallucinations and/or delusions (H&D) at some point during course of their disease 1,2 SYMPTOMS Seeing, hearing or experiencing things that others don’t Believing things that are not true Overview of Parkinson's-Related Hallucinations and Delusions 10 are treated with an atypical antipsychotic annually4 ~130,000 ~20% Opportunity to continue driving awareness, which has moved from ~10% to ~20% of caregivers and patients aware that hallucinations and delusions are associated with PD 3 1. https://www.parkinson.org/understanding-parkinsons/statistics. Accessed June 13, 2025. *Americans 65 and older. 2. Cummings J, et al. J Prev Alzheimers Dis. 2018;5(4):253-258. 3. Source: Acadia confidential market research on unaided awareness. 4. Acadia estimate as of June 2024 based on claims data.
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1. Based on latest Acadia internal estimates as of December 2025. NUPLAZID is only approved in the U.S. NUPLAZID for the Treatment of Parkinson’s-Related Hallucinations and Delusions The first and only FDA-approved drug for the treatment of hallucinations and delusions associated with Parkinson’s disease psychosis 11 Patients treated since launch1~97K ~25% Share of ~130,000 patients on atypical antipsychotics 1 2038 Patent protection
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NUPLAZID Sales Potential and Outlook Investing in NUPLAZID to Unlock Future Value ~$1 Billion Sales Potential in 2028 Executing a 30% increase in customer-facing teams to serve expanding customer base in Q1 26 Direct-to-consumer campaigns accelerating patient & caregiver awareness of Parkinson's H&D Precision execution of larger field force powered by AI 12
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SH Rare Disease 13
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1. Acadia market research. 2. Neul JL et al, Annal Neurol. 2010;68;944-50. 3. https://www.rettsyndrome.org/about-rett-syndrome/what-is-rett- syndrome/. 4. Based on Acadia Pharmaceuticals analysis of claims data as of 2024. 5. Based on Acadia internal estimates. Overview of Rett Syndrome Typically caused by mutations in the MECP2 gene disrupting the function of MECP2 protein crucial for brain development and function DEBILITATING SYMPTOMS OF RETT SYNDROME 1-3 Fine and gross motor impairments Loss of verbal and nonverbal communication Hand stereotypies Loss of independence and need for 24/7 support GI symptoms, including severe constipation Seizures ~6,000 Diagnosed patients in the U.S. 4 with a prevalent population of ~6,000-9,000 ~9,000-12,000 14 prevalent population in the EU 5
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Patients in the LOTUS real-world observational study SEEKING APPROVAL IN EU – CHMP OPINION ANTICIPATED Q1 2026 ~55% >300 Persistency at 12 months 1 DAYBUE First and Only Approved Treatment for Rett Syndrome Patients treated since launch1>2,000 The first and only FDA-approved drug for the treatment of Rett syndrome in adults and pediatric patients 2 years of age and older Based on Acadia internal estimates. 1. Based on latest Acadia internal data as of December 2025. DAYBUE is only approved in the U.S., Canada and Israel. 15
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DAYBUE Global Sales Potential and Outlook Key Drivers of Growth ~$700 Million Sales Potential in 2028 Continued benefits of Q2 2025 expansion of customer-facing teams powered by AI International expansion Introduction of STIX formulation in the U.S. 16
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DAYBUE STIX: A New Formulation Based on Rett Community Feedback Key Attributes Flexible reconstitution liquids and volumes No refrigeration required Highly portable Lower sugar/carbohydrate content Potential Benefits Enables caregiver customization to the taste/volume preference of the patient Enables patient growth from families who had declined to try liquid formulation Enables growth from restart patients who discontinued liquid formulation Powder for oral solution expected to deliver the same efficacy and safety profile, approved by U.S. FDA December 12, 2025 17 DAYBUE STIX is only approved in the United States.
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Pipeline 18
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Neurological and Rare Diseases Products and Pipeline Product candidates and investigational agents, for which the safety and efficacy of these agents have not been established. There is no guarantee these investigational agents will be filed with or approved by any regulatory agency. More information regarding licensed product candidates (ACP-211, ACP-711, ACP-271, ACP-2591 and Stoke ASO) available in Acadia's public filings. Rare diseases DAYBUE® Rett Syndrome Analog of GPE ACP-2591 Rett Syndrome, Fragile X Syndrome cGP analog ACP-271 Huntington’s Disease GPR88 agonist STOKE ASO SYNGAP1 Antisense oligonucleotide (ASO) PROGRAM INDICATION MOLECULE DESCRIPTION DISCOVERY IND ENABLING PHASE 1 PHASE 2 PHASE 3 LAUNCHED Neurological diseases NUPLAZID® Parkinson's Disease Psychosis 5HT2A inverse agonist and antagonist Remlifanserin (ACP-204) Alzheimer's Disease Psychosis New 5HT2A inverse agonist Remlifanserin (ACP-204) Lewy Body Dementia w/ Psychosis New 5HT2A inverse agonist ACP-211 Major Depressive Disorder Deuterated R-norketamine ACP-711 Essential Tremor Selective GABAA-α3 modulator ACP-271 Tardive Dyskinesia GPR88 agonist 19
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1. Cummings J, et al. J Prev Alzheimers Dis. 2018;5(4):253-258. A condition in which a person with Alzheimer's disease experiences hallucinations or delusions There are no approved treatments for hallucinations and delusions associated with ADP Overview of Alzheimer’s Disease Psychosis (ADP) ~7M Patients in the U.S. with Alzheimer’s disease Approximately 30% of patients with Alzheimer’s disease experience psychosis commonly consisting of hallucinations and delusions 1 20
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Remlifanserin (ACP-204) Molecule and Program Built On Learnings from Pimavanserin Minimize or eliminate QT prolongation Faster time to steady state Enable dose ranging to higher exposures Ensure appropriate study patient population Once-daily dosing Can be taken with or without food No drug-drug interactions with commonly used medications for Alzheimer's and Lewy Body Dementia Differentiation from Pimavanserin: Designed Patient- centric dosing attributes: 21
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Global, placebo-controlled, double -blind Phase 2 enrolling ADP = Alzheimer’s Disease Psychosis; QD = once daily; SAPS-H+D = Scale for Assessment of Positive Symptoms - Hallucinations + Delusions; CGI-S-ADP = Clinical Global Impression–Severity in ADP NPI-C H+D = Neuropsychiatric Inventory–Clinician Hallucinations + Delusions; NCT06159673 PHASE 2 N=318, double-blind, randomized 1:1:1 TWO PHASE 3 STUDIES Placebo Remlifanserin (60 mg QD) Remlifanserin (30 mg QD) Operationally seamless, statistically separate PRIMARY ENDPOINT SAPS-H+D total score change from baseline to Week 6 KEY SECONDARY ENDPOINT CGI-I-ADP EXPLORATORY ENDPOINT NPI-C H+D (among others) Placebo Remlifanserin (60 mg QD) Remlifanserin (30 mg QD) 6 WEEKS 6 WEEKS Remlifanserin (ACP-204): RADIANT Phase 2/Phase 3 Trial in ADP 22
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1. Simuni T, Chahine LM, Poston K, et al. A biological definition of neuronal α-synuclein disease: towards an integrated staging system for research. Lancet Neurol. 2024 Feb;23(2):178-190. doi: 10.1016/S1474-4422(23)00405-2. PMID: 38267190. 2. https://www.alzheimers.gov/alzheimers-dementias/lewy-body-dementia or https://www.lbda.org/wp-content/uploads/2021/03/lewy-body- dementia-booklet.pdf 3. Lewy Body Dementia Association (LBDA), Treatment of Lewy Body Dementiahttps://www.lbda.org/treatment/ 4. NINDS https://www.ninds.nih.gov/current-research/focus-disorders/alzheimers-disease-and-related-dementias/focus-lewy-body-dementia-lbd- research. 5. Cummings J, et al. J Prev Alzheimers Dis. 2018;5(4):253-258. . 6. Based on IQVIA data and Acadia internal estimates. >1M Patients in the U.S. may be living with LBD4 Overview of Lewy Body Dementia (LBD) A progressive brain disorder that affects thinking, movement, mood, and behavior that is associated with abnormal deposits of alpha-synuclein in the brain1,2 No therapies are approved for LBD with psychosis (LBDP); and some traditional antipsychotics that are commonly used in other diseases can be harmful3 50%-75% of people with LBD experience psychosis 5 Approximately 200,000 patients living with LBDP are being treated with antipsychotics 6 23
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LBDP Includes Two Distinct Patient Populations with Highly Related Symptomatology Dementia with Lewy Bodies Psychosis Parkinson's Disease Dementia Psychosis Lewy Body Dementia with Psychosis (LBDP) Cognitive impairment precedes motor symptoms Motor symptoms precede cognitive impairment Related by alpha-synuclein biology 24
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Pimavanserin Data Support Potential Efficacy of Remlifanserin in LBDP 5.3% (1 of 19) patients receiving pimavanserin 55% (11 of 20) receiving placebo % of patients experiencing relapse1: In the HARMONY study, patients who achieved a response were randomized to continue treatment with pimavanserin, or have treatment withdrawn (receive placebo) for up to 26 weeks 1. Torres-Yaghi Y, et al. Safety and efficacy of pimavanserin in patients with Lewy body dementia experiencing dementia-related psychosis in the HARMONY study. BMC Neurol. 2025 Nov 24;25(1) 25
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CGI-S = Clinical Global Impressions – Severity; QD = once daily; SAPS = Scale for Assessment of Positive Symptoms; NCT07029581 PRIMARY ENDPOINT SAPS-LBDP at 6 Weeks KEY SECONDARY ENDPOINT CGI-S-LBDP EXPLORATORY BIOMARKER Skin biopsy for neuronal α-synuclein disease 4 WEEKS Global, placebo-controlled, double -blind Phase 2 enrolling RANDOMIZATION OF PATIENTS STRATIFIED BY DIAGNOSIS DOUBLE- BLIND TREATMENT PERIOD Parkinson’s Disease Dementia Psychosis (50% cap) 6 WEEKS 6 WEEKS Remlifanserin (ACP-204): ILLUMERA Phase 2 Randomized, Placebo-Controlled Trial in LBDP Dementia with Lewy Bodies Psychosis Remlifanserin (60 mg QD) n=60 Remlifanserin (30 mg QD) n=60 Placebo n=60 SAFETY FOLLOW- UP 26
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Rationale for Development 1. https://www.mayoclinic.org/diseases-conditions/depression/symptoms-causes/syc-20356007. Accessed June 16, 2025. 2. Fekadu N, et al. J Depress Anxiety. 2017;6(1):255-7. 3. Karrouri R, et al. World J Clin Cases. 2021 Nov 6;9(31):9350-9367. ACP-211: Major Depressive Disorder (MDD) A common and serious medical illness that is marked by persistent sadness and loss of interest, often leading to emotional and physical problems 1,2 Unmet Need Current approved treatments for Major Depressive Disorder can be limited by extent and onset of efficacy, or show quick antidepressant impact but require extensive in-office medical monitoring because of sedation and dissociation 3 27 ACP-211 designed as an oral therapy with potential for ketamine-like efficacy, targeting minimal required in-office monitoring 2626 27
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Pervasive Disease Burden and Unmet Need in MDD 1. https://www.nimh.nih.gov/health/statistics/major-depression 2. Zhdanava M, et al. J Clin Psychiatry 2021; 82(2):20m13699. 3. JAMA 2013; 310:591 4. Ranked by years lived with disability in 2010 5. Greenberg PE, et al. Pharmacoeconomics. 2021 Jun;39(6):653-665. ~21M Adults with MDD1 ~9M medically treated in the U.S. 2 ~3M Patients with treatment- resistant depression in the U.S.2 Economic burden in the U.S. (2020 values)5 2 ~$326B Highest cause of disability (all diseases)3,4 ND 28
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SCREENING PERIOD DOUBLE- BLIND TREATMENT PERIOD Placebo ACP-211 low dose ACP-211 high dose PRIMARY ENDPOINT ∆ MADRS Total at Week 4 MDD patients with inadequate response to antidepressant treatment N=153 randomized 1:1:1 21- UP TO 42 DAYS 4 WEEKS ACP-211: Phase 2, 4 -Week, Randomized, Double -Blind, Placebo-Controlled, Multicenter Study MADRS = Montgomery-Åsberg Depression Rating Scale; NCT07284667. Phase 2 recently initiated 29
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Rationale for Development A movement disorder with high- frequency postural and/or kinetic tremor, mainly affecting the upper limbs1 Unmet Need Current treatments for essential tremor are not always effective and can have significant side effects. 2,3 No new pharmacological therapies have been approved in >50 years ACP-711 is a selective GABAA-a3 modulator targeting cerebellar GABA system dysfunction Phase 1 data to date support potential absence of cognitive or sedative effects and negative impact on sleep 30 ACP-711: Essential Tremor (ET) 1. Olanow CW, et al. In: Kasper DL, et al, eds. Harrison’s Principles of Internal Medicine. 19th ed. New York, NY: McGraw-Hill; 2015. 2. Ghanekar S, Zesiewicz T. Practical Neurology. 2023; September/October:20. https://practicalneurology.com/articles/2023-sept-oct/treatment-of-essential-tremor. 3. Louis ED, et al. Eur J Neurol. 2010;17:882-884.
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Pervasive Disease Burden and Unmet Need in ET 1. Louis ED, Ottman R. Tremor Other Hyperkinet Mov (N Y). 2014;4:259. 2. https://tremor.org.uk/essential-tremor. 3. Vetterick C, et al. Adv Ther. 2022 Dec;39(12):5546-5567 (a retrospective, observational study of a large US insurance claims database). ~7M Or 2.2% of the U.S. population is estimated to have ET1 Up to 10X More prevalent than Parkinson’s disease2 ~1M people Who were diagnosed with ET in the U.S. sought treatment 3 FROM 2015 TO 2019 31
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SCREENING PERIOD N=150 randomized 1:1:1 DOUBLE- BLIND TREATMENT PERIOD Placebo ACP-711 low dose ACP-711 high dose Phase 1 Elderly cohorts underway Phase 2 Projected study start Q4 2026 ENDPOINTS INCLUDE ∆ TETRAS-PS score at Week 4 ∆ TETRAS-ADL score at Week 4 ∆ CGI-I at Week 4 Essential Tremor Patients DAY- 28 TO 0 4 WEEKS ACP-711: Next Steps in Clinical Development 32 CGI-I = Clinical Global Impressions – Improvement; ADL = Activities of Daily Living; PS = Performance Scale; TETRAS = Essential Tremor Rating Assessment Scale.
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33 ACP-271: GPR88 Program Provides Unique Opportunities in the Treatment of Multiple Neurological Disorders GPR88 ACP- 271 Orally dosed potential first-in-class GPR88 agonist that may modulate the balance of D1 and D2 signaling without affecting dopamine levels Target indications in both Tardive Dyskinesia and Huntington’s Disease Anticipate initiating first-in-human study in healthy volunteers during Q1 2026 Graphical representation; not indicative of actual binding site. ACP-271 is an investigational agent, for which the safety and efficacy have not been established or approved by the FDA.
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ACP-271 Phase 1 in Healthy Volunteers ACP-711 Phase 2 in Essential Tremor 2026-2027 Anticipated Milestones Q1 Q3 Q4Q2 Remlifanserin (ACP-204) (ADP/LBDP) 2026 Q1 Q3 Q4Q2 FIRST PATIENT IN FIRST PATIENT IN 2027 Japan Phase 3 TrialCHMP Opinion Other Pipeline Programs Phase 2 in Alzheimer’s Disease Psychosis TOP-LINE RESULTS TOP-LINE RESULTS 34 ACP-211 Phase 2 Trial TOP- LINE RESULTS
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J.P. Morgan Healthcare Conference Catherine Owen Adams Chief Executive Officer January 13, 2026 35