All references to non-GAAP are reconciled with the most directly comparable GAAP financial measures in our earnings press release and slide presentation, which has been posted on the investor page of the company's website. We also continue to make important progress across our pipeline, led by remlifanserin in Alzheimer's disease psychosis. We achieved total revenues of $308 million in the second quarter, representing 17% year-over-year growth on an adjusted basis. This performance reflects strong execution and continued demand for DAYBUE and NUPLAZID.

Turning to DAYBUE, the brand delivered net sales of $125 million in the second quarter, representing 30% year-over-year growth. The strong early adoption of DAYBUE STIX reinforces our confidence in this differentiated delivery option and supports the brand's continued growth trajectory. Based on these strong results, we are raising our 2026 guidance range for DAYBUE to $480 million-$510 million. The underlying business remains strong, supported by continued demand growth, disciplined execution, and impact from our expanded field force.

Looking ahead, our most important near-term pipeline milestone is the upcoming phase II readout for remlifanserin in Alzheimer's disease psychosis. I am excited to report another strong quarter for DAYBUE, which generated $125 million in net sales in the second quarter, representing 30% year-over-year growth, driven almost entirely by volume. Demand trends accelerated during the quarter as we expanded the launch of DAYBUE STIX beyond Centers of Excellence, which is engaging new patients and bringing previously discontinued patients back to therapy. Importantly, the number of patients returning to DAYBUE reached a record level during the second quarter.

What went well
  • Total revenue was $308 million, up 17% year over year on an adjusted basis, an outstanding quarter across both brands.
  • DAYBUE net sales jumped 30% year over year to $125 million (27% volume), driven by rapid DAYBUE STIX uptake — about 40% of U.S. DAYBUE patients were on STIX by quarter-end and returning patients hit a record; guidance was raised as a result.
  • ACADIA won a positive CHMP opinion for trofinetide in the EU following the reexamination — reversing the earlier negative trend vote — clearing the way toward European Commission approval and a planned Germany launch in early Q4.
  • NUPLAZID grew 10% year over year (adjusted) to $183 million (8% volume), with new patient prescriptions up 20% year over year — the highest quarterly volume since Q1 2018 — as the expanded field force reached more than 12,000 priority HCPs since February.
  • The remlifanserin Alzheimer's disease psychosis Phase II (RADIANT) completed enrollment (363 patients), earned FDA Fast Track designation, and top-line results were tightened to September-October 2026; Phase III studies opened for enrollment under the seamless design.
  • Cash climbed to $956 million, and R&D spend guidance was lowered, reflecting disciplined portfolio management.
What went wrong
  • SG&A remained elevated at $160 million (up from $134 million) on continued NUPLAZID and DAYBUE field-force and marketing investments.
  • The R&D guidance reduction to $355-$380 million was driven partly by a business-development milestone (ACP-711) shifting to 2027 and selected portfolio-prioritization decisions, signaling some program timing slippage.
  • European commercialization will ramp gradually — only initial EU (Germany) sales are expected in Q4, with pricing/reimbursement negotiations (six-month German free-pricing window, then AMNOG) and other-market launches still ahead.
  • The Japan trofinetide filing strategy remains contingent on selecting a commercialization partner that had not yet been named, and the pivotal remlifanserin ADP readout — the company's most important near-term catalyst — is still pending in September-October.

Guidance Changes

MetricPeriodCurrent guidance
Total revenueFY2026$1.24B-$1.30B (raised)
DAYBUE net salesFY2026$480M-$510M (raised; includes initial EU commercial sales in Q4); gross-to-net 23%-25%
NUPLAZID net salesFY2026$760M-$790M (unchanged)
R&D expenseFY2026$355M-$380M (lowered; BD milestone shifted to 2027 plus portfolio prioritization)
Remlifanserin ADP Phase II (RADIANT) readout2026September-October 2026 (tightened)
DAYBUE / NUPLAZID long-term2028Reaffirmed ~$700M DAYBUE and ~$1B NUPLAZID (~$1.7B combined commercial peak)

Performance Breakdown

MetricYoYNote
Total revenue +17% (adjusted) to $308M Strong execution across DAYBUE and NUPLAZID.
DAYBUE net sales +30% to $125M (27% volume) Rapid DAYBUE STIX adoption (~40% of U.S. patients) and record returning patients; gross-to-net 24.4%.
NUPLAZID net sales +10% to $183M (8% volume) New patient prescriptions +20% YoY (highest since Q1 2018) as the expanded field force ramped; gross-to-net 23.9%.
R&D expense $82M vs $78M Continued pipeline advancement.
SG&A expense $160M vs $134M NUPLAZID and DAYBUE field-force expansions and increased marketing.
Cash and investments $956M Strong operating cash generation, providing flexibility for pipeline and business development.

Earnings Call Themes & Trends

TopicPrevious mentionCurrent periodTrend
DAYBUE STIX momentumCOE-focused Q1 launchBroad rollout drove ~40% of U.S. DAYBUE patients onto STIX by quarter-end; by June ~60% of all referrals were STIX, with a diverse mix of naive, returning and switching patients, supporting raised DAYBUE guidance.
Trofinetide EU approval pathNegative CHMP trend vote, reexamination underwayPositive CHMP opinion secured on reexamination; EC decision expected later in Q3; Germany launch planned early Q4 with Austria/Nordics to follow and initial EU commercial sales now in guidance.
Remlifanserin ADP programEnrollment ongoing; readout Aug-OctPhase II (RADIANT) enrollment complete at 363 patients, FDA Fast Track granted, readout tightened to September-October; two Phase III studies (30 mg and 60 mg arms) now open for enrollment under the operationally seamless design; ~$4 billion peak potential split roughly 60% ADP / 40% LBDP.
R&D spend discipline$385M-$410M guidanceLowered to $355M-$380M as an ACP-711 BD milestone shifted to 2027 (added higher-dose Phase I exploration) and selected portfolio-prioritization decisions were made.

Q&A Summary

Tessa Romero (JPMorgan) asked how to think about RADIANT effect-size scenarios and the lower bound that still enables Phase III.
Catherine Owen Adams said the study is 80% powered for a moderate 0.4 effect size on SAPS-H&D with some flexibility around it, and the team will weigh responder analyses and other endpoints plus safety, cognition and motor signals to judge whether the asset is Phase III-enabling.
Marc Goodman (Leerink) asked ACADIA to quantify the DAYBUE Europe opportunity and ramp.
Tom Garner said the EC decision is expected by end of Q3 with Germany the launch market in early Q4, followed by the Nordics and Austria, and a gradual ramp as free-drug patients transition to paid treatment; Catherine Owen Adams noted European country onboarding takes years and named patient programs continue in parallel.
Malcolm Hoffman (BMO) asked whether NUPLAZID refill rates had normalized after the Q1 issue.
Tom Garner said referral and restart rates are exactly where expected, with a particularly good rebound versus prior years, confirming the Q1 dynamic was a one-off.
Sumant Kulkarni (Canaccord Genuity) asked about confidence in the ~$1.7 billion 2028 commercial peak for the two brands.
Catherine Owen Adams reaffirmed confidence in ~$1 billion NUPLAZID and ~$700 million DAYBUE by 2028, to be revisited later in the year as STIX uptake and NUPLAZID trends play out.
Uy Ear (Mizuho) asked about RADIANT patient numbers, the September-versus-October gating, and which program's milestone shifted.
Elizabeth Thompson said 363 patients enrolled in the Phase II, the main gating factor between September and October is the 30-day safety follow-up for patients not rolling into the open-label extension, and the shifted milestone was ACP-711, delayed by added higher-dose Phase I work.
David Huang (Deutsche Bank) asked about differing probability of success and the commercial split for remlifanserin across ADP and LBDP.
Elizabeth Thompson said probability of success is not seen as wildly different between the indications (more pimavanserin data in Alzheimer's, but striking, if smaller, Lewy body data); Catherine Owen Adams put the ~$4 billion peak split at roughly 60% ADP / 40% LBDP, subject to data and competition.

More on Acadia Pharmaceuticals Inc

Reported 2026-08-04 · figures from the Acadia Pharmaceuticals Inc Q2 2026 earnings call.

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