Axsome Therapeutics (AXSM) 10-Q 2 May 22 2022 Q1 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	3 Months Ended
	Mar. 31, 2022	Apr. 26, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Mar. 31, 2022
Entity File Number	001-37635
Entity Registrant Name	AXSOME THERAPEUTICS, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	45-4241907
Entity Address, Address Line One	22 Cortlandt Street
Entity Address, Address Line Two	16th Floor
Entity Address, City or Town	New York
Entity Address, State or Province	NY
Entity Address, Postal Zip Code	10007
City Area Code	212
Local Phone Number	332-3241
Title of 12(b) Security	Common Stock, Par Value $0.0001 Per Share
Trading Symbol	AXSM
Security Exchange Name	NASDAQ
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		38,913,550
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Entity Central Index Key	0001579428
Amendment Flag	false

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 84,707,782	$ 86,472,854
Prepaid and other current assets	2,122,144	45,286
Total current assets	86,829,926	86,518,140
Equipment, net	460,946	283,846
Right-of-use asset - operating lease	946,479	660,162
Other assets	322,910	322,910
Total assets	88,560,261	87,785,058
Current liabilities:
Accounts payable	12,595,112	13,149,329
Accrued expenses and other current liabilities	10,987,222	9,295,180
Operating lease liability, current portion	967,248	620,675
Total current liabilities	24,549,582	23,065,184
Loan payable, long-term	49,312,665	49,089,522
Total liabilities	73,862,247	72,154,706
Stockholders’ equity:
Common stock, $0.0001 par value per share (150,000,000 shares authorized, 38,883,445 and 37,816,794 shares issued and outstanding at March 31, 2022 and December 31, 2021, respectively)	3,888	3,782
Additional paid-in capital	463,525,522	424,825,655
Accumulated deficit	(448,831,396)	(409,199,085)
Total stockholders’ equity	14,698,014	15,630,352
Total liabilities and stockholders’ equity	$ 88,560,261	$ 87,785,058

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - $ / shares	Mar. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Preferred stock, par value	$ 0.0001	$ 0.0001
Preferred stock, shares authorized	10,000,000	10,000,000
Preferred stock, shares issued	0	0
Preferred stock, shares outstanding	0	0
Common stock, par value	$ 0.0001	$ 0.0001
Common stock, shares authorized	150,000,000	150,000,000
Common stock, shares issued	38,883,445	37,816,794
Common stock, shares outstanding	38,883,445	37,816,794

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Operating expenses:
Research and development	$ 12,585,141	$ 16,595,689
General and administrative	25,703,731	11,248,372
Total operating expenses	38,288,872	27,844,061
Loss from operations	(38,288,872)	(27,844,061)
Interest income (expense)	(1,343,439)	(1,415,909)
Net loss	$ (39,632,311)	$ (29,259,970)
Net loss per common share, basic and diluted	$ (1.03)	$ (0.78)
Weighted average common shares outstanding, basic and diluted	38,323,167	37,429,450

Consolidated Statements of Stoc

Consolidated Statements of Stockholders' Equity - USD ($)	Total	Common Stock	Additional Paid-in Capital	Accumulated Deficit
Beginning balance at Dec. 31, 2020	$ 113,792,909	$ 3,737	$ 392,585,265	$ (278,796,093)
Balance (in shares) at Dec. 31, 2020		37,374,088
Stock-based compensation	3,731,097		3,731,097
Issuance of common stock upon exercise of options	1,913,299	$ 10	1,913,289
Issuance of common stock upon exercise of options (in shares)		94,000
Issuance of common stock upon vesting of RSUs		$ 0
Issuance of common stock upon vesting of RSUs (in shares)		1,917
Issuance of common stock upon financing	6,115,864	$ 9	6,115,855
Issuance of common stock upon financing (in shares)		93,877
Net loss	(29,259,970)			(29,259,970)
Ending balance at Mar. 31, 2021	96,293,199	$ 3,756	404,345,506	(308,056,063)
Balance (in shares) at Mar. 31, 2021		37,563,882
Beginning balance at Dec. 31, 2021	$ 15,630,352	$ 3,782	424,825,655	(409,199,085)
Balance (in shares) at Dec. 31, 2021	37,816,794	37,816,794
Stock-based compensation	$ 7,598,329		7,598,329
Issuance of common stock upon exercise of options	$ 181,637	$ 2	181,635
Issuance of common stock upon exercise of options (in shares)	18,015	18,015
Issuance of common stock upon vesting of RSUs		$ 0
Issuance of common stock upon vesting of RSUs (in shares)		4,555
Issuance of common stock upon financing	$ 31,008,601	$ 104	31,008,497
Issuance of common stock upon financing (in shares)		1,044,081
Shares tendered for withholding taxes	(88,594)	$ 0	(88,594)
Net loss	(39,632,311)			(39,632,311)
Ending balance at Mar. 31, 2022	$ 14,698,014	$ 3,888	$ 463,525,522	$ (448,831,396)
Balance (in shares) at Mar. 31, 2022	38,883,445	38,883,445

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Cash flows from operating activities
Net loss	$ (39,632,311)	$ (29,259,970)
Adjustments to reconcile net loss to net cash used in operating activities:
Stock-based compensation expense	7,598,329	3,731,097
Amortization of debt discount	223,143	276,095
Depreciation	36,636	8,326
Amortization of operating lease right-of-use asset	275,063	262,764
Change in operating lease liability	(214,807)	(275,840)
Changes in operating assets and liabilities:
Prepaid expenses and other current assets	(2,076,858)	(226,933)
Accounts payable	(554,217)	1,117,695
Accrued expenses and other current liabilities	1,692,042	(2,848,723)
Net cash used in operating activities	(32,652,980)	(27,215,489)
Cash flows from investing activities
Purchases of equipment	(213,736)	(29,995)
Net cash used in investing activities	(213,736)	(29,995)
Cash flows from financing activities
Proceeds from issuance of common stock upon financing, net	31,008,601	6,115,864
Proceeds from issuance of common stock upon exercise of options	181,637	1,913,299
Payments of tax withholdings on stock award	(88,594)
Net cash (used in) provided by financing activities	31,101,644	8,029,163
Net (decrease) increase in cash	(1,765,072)	(19,216,321)
Cash at beginning of period	86,472,854	183,876,453
Cash at end of period	84,707,782	164,660,132
Supplemental disclosures of cash flow information:
Interest paid	1,118,750	$ 1,143,750
Operating lease right-of-use asset obtained in exchange for operating lease liability	$ 561,380

Nature of Business and Basis of

Nature of Business and Basis of Presentation	3 Months Ended
	Mar. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Nature of Business and Basis of Presentation	Note 1. Nature of Business and Basis of Presentation Axsome Therapeutics, Inc. (“Axsome” or the “Company”) is a biopharmaceutical company developing novel therapies for central nervous system (“CNS”) disorders for which there are limited treatment options. By focusing on this therapeutic area, the Company is addressing significant and growing markets where current treatment options are limited or inadequate. The Company’s core CNS portfolio includes four product candidates, AXS-05, AXS-07, AXS-12, and AXS-14, which are being developed for multiple indications. The Company aims to become a fully integrated biopharmaceutical company that develops and commercializes differentiated therapies that expand the treatment options available to caregivers and improve the lives of patients living with CNS disorders. The Company was incorporated on January 12, 2012 in the State of Delaware. The accompanying unaudited interim consolidated financial statements have been prepared by the Company in accordance with accounting principles generally accepted in the United States (“U.S. GAAP”) for interim information and pursuant to the rules and regulations of the Securities and Exchange Commission (the “SEC”) for reporting on Form 10-Q. Accordingly, certain information and footnote disclosures normally included in financial statements prepared in accordance with U.S. GAAP have been condensed or omitted pursuant to such rules and regulations. These unaudited interim consolidated financial statements should be read in conjunction with the audited financial statements and related notes included in the Company’s Annual Report on Form 10-K for the year ended December 31, 2021 filed with the SEC on March 1, 2022. In the opinion of management, the unaudited interim consolidated financial statements reflect all adjustments, which are normal recurring adjustments, necessary for the fair presentation of the financial information for the interim periods. The results of operations for the three months ended March 31, 2022 are not necessarily indicative of the operating results for the full fiscal year or any future period. Acquisition of Assets of Jazz Pharmaceuticals On March 25, 2022, the Company entered into an Asset Purchase Agreement (the “Asset Purchase Agreement”) with Jazz Pharmaceuticals plc ("Jazz Pharmaceuticals"), pursuant to which the Company will acquire Sunosi® from Jazz Pharmaceuticals ("the Acquisition"), a dual-acting dopamine and norepinephrine reuptake inhibitor indicated to improve wakefulness in adult patients living with excessive daytime sleepiness due to narcolepsy or obstructive sleep apnea, which was approved by the U.S. Food and Drug Administration, or the FDA, in 2019 and by the European Medicines Agency (the “EMA”) in 2020. Under the terms of the Asset Purchase Agreement, the Company will receive from Jazz Pharmaceuticals worldwide commercial, development, manufacturing, and intellectual property rights to Sunosi, except for certain Asian markets. Jazz Pharmaceuticals will receive from the Company a total upfront payment of $ 53 million, a high single-digit royalty on the Company's U.S. net sales of Sunosi in the current indication, and a mid single-digit royalty on the Company's U.S. net sales of Sunosi in future indications. The Company will also assume the commitments of Jazz Pharmaceuticals to SK Biopharmaceuticals (“SK)” and Aerial Biopharma (“Aerial”). SK is the originator of Sunosi and retains rights in 12 Asian markets, including China, Korea, and Japan. In 2014, Jazz Pharmaceuticals acquired from Aerial worldwide rights to Sunosi excluding those Asian markets. The assumed commitments to SK and Aerial include single-digit tiered royalties based on the Company's sales of Sunosi, and up to $ 165 million in revenue milestones and $ 1 million in development milestones. The Company expects to finance the transaction via its existing $ 300 million term loan facility with Hercules Capital, Inc. (see below). The Purchase Agreement also provides for customary conditions to closing, including the receipt of antitrust approval from the Federal Trade Commission pursuant to the Hart-Scott-Rodino Act, and the receipt of certain required financial statements from Jazz required by Regulation S-X of the Securities Exchange Act of 1934, as amended. The Company expects the closing to occur in the second quarter of 2022 and therefore, purchase accounting is not reflected in these consolidated financial statements. Second Amendment to the Loan and Security Agreement On March 27, 2022, in connection with the Acquisition (as described above), the Company entered into a Second Amendment to the Loan and Security Agreement (the “Second Amendment”) with Hercules Capital, Inc. The Second Amendment amends the terms of that certain Loan and Security Agreement, dated as of September 25, 2020 (as amended by the First Amendment to the Loan and Security Agreement, dated of October 14, 2021) (the “Loan Agreement”). The changes in the Term Loan Advances (as defined in the Loan Agreement) amounts and dates are as follows: (i) increasing the Tranche 1 (as defined in the Loan Agreement) from $ 60.0 million to $ 95.0 million, whereby $ 45.0 million is available upon the Second Amendment closing date (ii) changing the Tranche 2 Advances (as defined in the Loan Agreement) from two sub-tranches of $ 50.0 million each to three sub-tranches of $ 35.0 million, $ 35.0 million and $ 30.0 million, respectively, (iii) changing the Tranche 3 Advance (as defined in the Loan Agreement) from one tranche of $ 20.0 million to two sub-tranches of $ 15.0 million and $ 5.0 million, respectively, (iv) decreasing the Tranche 4 Advance (as defined in the Loan Agreement) from $ 55.0 million to $ 50.0 million, and (v) decreasing the Tranche 5 Advance (as defined in the Loan Agreement) from $ 75.0 million to $ 35.0 million. In connection with the Second Amendment, the parties also clarified certain terms of the Warrant Agreement previously issued to Hercules. The Second Amendment shall only be effective upon the closing of the Acquisition. Conditioned upon the closing of the Second Amendment, Hercules will also purchase between $ 5.0 million and $ 8.0 million of the Company’s unregistered common stock, at a share price equal to the lesser of (a) the three-day volume weighted average price as of the date of the Second Amendment, or (b) the three-day volume weighted average price as of the Second Amendment Effective Date, pursuant to a stock purchase agreement to be agreed upon by the parties; provided, that, in no case shall the share price be less than a 20 % discount to the three-day volume weighted average price of the Company’s common stock at the time of the purchase. Liquidity and Capital Resources The Company has incurred operating losses since its inception and expects to continue to incur operating losses for the foreseeable future and may never become profitable. As of March 31, 2022, the Company had an accumulated deficit of $ 448.8 million. The Company’s primary sources of cash have been proceeds from the issuance and sale of its common stock in public offerings and the issuance of debt. The Company has not yet commercialized any of its product candidates and cannot be sure if it will ever be able to do so. The Company’s ability to achieve profitability depends on a number of factors, including its ability to obtain regulatory approval for its product candidates, successfully complete any post-approval regulatory obligations and successfully commercialize its product candidates alone or in partnership. The Company may continue to incur substantial operating losses even if it begins to generate revenues from its product candidates. The Company believes its existing cash will be sufficient to fund its anticipated operating cash requirements for at least twelve months following the date of this filing. The actual amount of cash that the Company will need to operate is subject to many factors, including, but not limited to, the timing, design and conduct of clinical trials for its product candidates. The Company may use a combination of public and private equity offerings, debt financings, other third-party funding, strategic alliances, licensing arrangements or marketing and distribution arrangements if market conditions are favorable or as a result of other strategic considerations to finance its future cash needs. The Company’s common stock is listed on the Nasdaq Global Market and trades under the symbol “AXSM”. Impact of COVID-19 In December 2019, a novel (new) coronavirus known as SARS-CoV-2 was first detected in Wuhan, Hubei Province, People’s Republic of China, causing outbreaks of the coronavirus disease, known as COVID-19, that has now spread globally. On January 30, 2020, the World Health Organization (WHO) declared COVID-19 a public health emergency. The Secretary of Health and Human Services declared a public health emergency in the United States on January 31, 2020, under section 319 of the Public Health Service Act (42 U.S.C. 247d), in response to the COVID-19 outbreak. On March 11, 2020, the WHO declared COVID-19 a global pandemic. The full impact of the ongoing COVID-19 pandemic is still unknown and rapidly evolving. While the potential economic impact brought by and over the duration of the COVID-19 pandemic may be difficult to assess or predict, the COVID-19 pandemic has resulted in significant disruption of global financial markets, which could in the future negatively affect the Company’s liquidity. In addition, a recession or market volatility resulting from the COVID-19 pandemic could affect the Company’s business. Given the nature and type of the Company’s short-term investments, the Company does not believe the COVID-19 pandemic has had or will have a material impact on the Company’s current investment liquidity.

Summary of Significant Accounti

Summary of Significant Accounting Policies	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Summary of Significant Accounting Policies	Note 2. Summary of Significant Accounting Policies Significant Risks and Uncertainties The Company’s operations are subject to a number of factors that can affect its operating results and financial condition. Such factors include, but are not limited to: the results of clinical testing and trial activities of the Company’s product candidates; the Company’s ability to obtain regulatory approval to market its products, if approved; competition from products manufactured and sold or being developed by other companies; the price of, and demand for, the Company’s products, if approved; the Company’s ability to negotiate favorable licensing or other manufacturing and marketing agreements for its products, if approved; and the Company’s ability to raise additional financing. If the Company does not successfully commercialize any of its product candidates, it will be unable to generate recurring product revenue or achieve and maintain profitability. Use of Estimates Management considers many factors in developing the estimates and assumptions that are used in the preparation of these financial statements. Management must apply significant judgment in this process. In addition, other factors may affect estimates, including expected business and operational changes, sensitivity and volatility associated with the assumptions used in developing estimates, and whether historical trends are expected to be representative of future trends. The estimation process often may yield a range of potentially reasonable estimates of the ultimate future outcomes and management must select an amount that falls within that range of reasonable estimates. This process may result in actual results differing materially from those estimated amounts used in the preparation of the financial statements if these results differ from historical experience, or other assumptions do not turn out to be substantially accurate, even if such assumptions are reasonable when made. In preparing these financial statements, management used significant estimates in the following areas, among others: stock‑based compensation expense; the determination of the fair value of the warrants; the accounting for research and development costs; and the recoverability of the Company’s net deferred tax assets and related valuation allowance. Foreign Currency Translation Expenses denominated in foreign currency are translated into U.S. dollars at the exchange rate on the date the expense is incurred. Assets and liabilities of foreign operations are translated at period-end exchange rates. The effect of exchange rate fluctuations on translating foreign currency into U.S. dollars is included in the Statements of Operations and is not material to the Company’s financial statements. Segment and Geographic Information Operating segments are defined as components of an enterprise for which separate discrete information is available for evaluation by the chief operating decision maker or decision-making group, in deciding how to allocate resources and in assessing performance. The Company views its operations and manages its business as one operating segment, which is the business of developing novel therapies for the management of CNS disorders. Cash Equivalents The Company considers all highly liquid investments that have maturities of three months or less when acquired to be cash equivalents. The Company’s cash and cash equivalents includes holdings in checking and overnight sweep accounts. The Company’s cash equivalents, which are money market funds held in a sweep account, are measured at fair value on a recurring basis. As of March 31, 2022 , the balance of cash and cash equivalents was $ 84.7 million, which approximates fair value and was determined based upon Level 1 inputs. The sweep account is valued using quoted market prices with no valuation adjustments applied. Accordingly, these securities are categorized as Level 1. Concentration of Credit Risk Financial instruments that potentially subject the Company to a concentration of credit risk consist of cash. The Company maintains its cash at financial institutions, which at times, exceed federally insured limits. At March 31, 2022 , the majority of the Company’s cash was held by one financial institution and the amount on deposit was in excess of Federal Deposit Insurance Corporation insurance limits. The Company has not recognized any losses from credit risks on such accounts since inception. The Company believes it is not exposed to significant credit risk on cash. Fair Value of Financial Instruments Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. Assets and liabilities that are measured at fair value are reported using a three‑level fair value hierarchy that prioritizes the inputs used to measure fair value. This hierarchy maximizes the use of observable inputs and minimizes the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: Level 1—Quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date. Level 2—Inputs other than quoted prices in active markets that are observable for the asset or liability, either directly or indirectly. Level 3—Inputs that are unobservable for the asset or liability. To the extent that valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. Accordingly, the degree of judgment exercised by the Company in determining fair value is greatest for instruments categorized in Level 3. A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. The Company’s financial instruments are cash, accounts payable, accrued liabilities, and current and long-term debt. The carrying values for cash, accounts payable and accrued liabilities reported in the accompanying consolidated financial statements approximate their respective fair values due to their short-term maturities. The carrying value of debt on the Company’s balance sheet (see Note 6 – Loan and Security Agreement), is estimated to approximate its fair value as the interest rate approximates the market rate for loans with similar terms and risk characteristics. Debt Issuance Costs Debt issuance costs consist of costs incurred in obtaining long-term financing. These costs are classified on the consolidated balance sheet as a direct deduction from the carrying amount of the related debt liability. These expenses are deferred and amortized as part of interest expense in the consolidated statement of operations using the effective interest rate method over the term of the debt agreement. Equipment Equipment consists primarily of computer equipment and is recorded at cost. Equipment is depreciated on a straight‑line basis over its estimated useful life, which the Company estimates to be three years . When equipment is sold or otherwise disposed of, the cost and related accumulated depreciation are removed from the accounts and the resulting gain or loss is included in operating expenses. Research and Development Costs Research and development costs are expensed as incurred. Research and development expenses consist primarily of employee-related expenses including salaries, benefits, travel, and stock‑based compensation expense, contract services, costs incurred to third-party service providers for the conduct of research, preclinical and clinical studies, laboratory supplies, product license fees, consulting and other related expenses. We estimate research, preclinical and clinical study expenses based on services performed, pursuant to contracts with third-party research and development organizations that conduct and manage research, preclinical and clinical activities on our behalf. We estimate these expenses based on discussions with internal management personnel and external service providers as to the progress or stage of completion of services and the contracted fees to be paid for such services. If the actual timing of the performance of services or the level of effort varies from the original estimates, we will adjust the accrual accordingly. Payments associated with licensing agreements to acquire licenses to develop, use, manufacture and commercialize products that have not reached technological feasibility and do not have alternative future use are expensed as incurred. Payments made to third parties under these arrangements in advance of the performance of the related services by the third parties are recorded as prepaid expenses until the services are rendered. Income Taxes Income taxes are accounted for under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to the differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases, operating losses, and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect of a change in tax rates on deferred tax assets and liabilities is recognized in income in the period that includes the enactment date. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company estimates an annual effective tax rate of 0 % for the year ending December 31, 2022 and has no t recorded an income tax benefit for the three months ended March 31, 2022 and 2021 since it determined that a full valuation allowance is required against the Company’s deferred tax assets. The Company recognizes the tax benefit from an uncertain tax position only if it is more likely than not to be sustained upon examination based on the technical merits of the position as well as consideration of the available facts and circumstances. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit will more likely than not be realized. As of March 31, 2022 , the Company does not believe any material uncertain tax positions are present. In the event the Company determines that accrual of interest or penalties are necessary in the future, the amount will be presented as a component of income tax expense. Stock-Based Compensation For stock options issued, the Company estimates the grant date fair value of each option using the Black‑Scholes option pricing model. The Black-Scholes model takes into account the expected volatility of the Company’s common stock, the risk-free interest rate, the estimated life of the option, the closing market price of the Company’s common stock and the exercise price. The estimates utilized in the Black-Scholes calculation involve inherent uncertainties and the application of management’s judgment. In addition, the Company recognizes expense for equity award forfeitures as they occur. For restricted stock units (“RSUs”), the Company issues them in the form of Company common stock. The fair market value of these awards is based on the market closing price per share on the grant date. For awards subject to service-based vesting conditions, the Company recognizes stock-based compensation expense on a straight-line basis over the requisite service period, which is generally the vesting term. For awards subject to performance-based vesting conditions, the Company recognizes stock-based compensation expense using the accelerated attribution method when it is probable that the performance condition will be achieved. The expense related to the stock-based compensation is recorded within the same financial statement line item as the grantee’s cash compensation. The Company’s policy upon exercise of stock options and RSUs is that shares will be issued as new shares drawing on the Company’s 2015 Omnibus Incentive Compensation Plan share pool that was adopted by the stockholders in November 2015. Basic and Diluted Net Loss per Common Share Basic net loss per share of common stock is computed by dividing net loss by the weighted average number of shares of common stock outstanding during the period. Diluted net loss per share of common stock includes the effect, if any, from the potential exercise or conversion of securities, such as warrants, stock options, and RSUs, which would result in the issuance of incremental shares of common stock. As the impact of these items is anti-dilutive during periods of net loss, there was no difference between basic and diluted net loss per share of common stock for the three months ended March 31, 2022 and 2021 . Leases The Company determines if an arrangement is a lease at contract inception. Operating lease assets represent the Company’s right to use an underlying asset for the lease term and operating lease liabilities represent the Company’s obligation to make lease payments arising from the lease. When evaluating whether a contract contains a lease, the Company considers whether (1) the contract explicitly or implicitly identifies assets that are contractually defined and (2) the Company obtains substantially all of the economic benefits from the use of that underlying asset and directs how and for what purpose the asset is used during the term of the contract. The Company’s lease agreement contains lease and non-lease components. Non-lease components primarily include payments for maintenance and utilities. The Company has applied the practical expedient to combine fixed payments for non-lease components with lease payments and account for them together as a single lease component, which increases the amount of lease assets and corresponding liabilities. Payments under the Company’s lease arrangement are primarily fixed, however variable payments, are expensed as incurred and not included in the operating lease asset and liability. Operating lease assets and liabilities are recognized at the commencement date of the lease based upon the present value of lease payments over the lease term. When determining the lease term, the Company includes options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. The Company uses the implicit interest rate when readily determinable and uses the Company’s incremental borrowing rate when the implicit rate is not readily determinable based upon the information available at the commencement date in determining the present value of the lease payments. The Company’s operating leases are reflected in the right-of-use operating asset; operating lease liability, current portion; and operating lease liability, long-term portion in the Company’s consolidated balance sheets. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. Short-term leases, defined as leases that have a lease term of 12 months or less at the commencement date, and do not include an option to extend the term or purchase the underlying asset that the Company is reasonably certain to exercise, are excluded from this treatment and are recognized on a straight-line basis over the term of the lease. Recent Accounting Pronouncements In October 2021, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2021-08, Business Combinations (Topic 805) . This update requires that an entity (acquirer) recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Accounting Standards Codification (“ASC”) 606. This differs from the current requirement to measure contract assets and contract liabilities acquired in a business combination at fair value. The amendments in this update should be applied prospectively, and are effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted, including adoption in an interim period. The Company is currently evaluating the impact of this ASU on its consolidated financial statements.

Accrued Expenses and Other Curr

Accrued Expenses and Other Current Liabilities	3 Months Ended
	Mar. 31, 2022
Accrued Liabilities and Other Liabilities [Abstract]
Accrued Expenses and Other Current Liabilities	Note 3. Accrued Expenses and Other Current Liabilities At March 31, 2022 and December 31, 2021 accrued expenses and other current liabilities consisted of the following: ​ March 31, December 31, Accrued research and development $ 2,726,847 $ 2,416,897 Accrued compensation 2,013,040 4,050,236 Accrued general and administrative 5,856,779 2,442,700 Accrued Interest 390,556 385,347 Total $ 10,987,222 $ 9,295,180

Loan and Security Agreement

Loan and Security Agreement	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Loan and Security Agreement	Note 4. Loan and Security Agreement Hercules Capital, Inc. In September 2020, the Company entered into a Loan and Security Agreement (the “Loan Agreement”) with Hercules Capital, Inc., in its capacity as administrative agent and collateral agent and as a lender (in such capacity, the “Agent” or “Hercules”) and the other financial institutions that from time to time become parties to the Loan Agreement as lenders (collectively, the “Lenders”). The Loan Agreement provides for term loans in an aggregate principal amount of up to $ 225.0 million under multiple tranches (the “2020 Term Loan”). The tranches consist of (i) a first tranche consisting of term loans in an aggregate principal amount of $ 60.0 million, of which $ 50.0 million was funded to the Company on the Closing Date (the “First Advance”), and of which the remaining $ 10.0 million was available at the Company’s option at any time through September 15, 2021; (ii) subject to the approval of the Company’s AXS-05 product candidate for the treatment of major depressive disorder (the “First Milestone”), a second tranche consisting of additional term loans in an aggregate principal amount of up to $ 35.0 million, available at the Company’s option beginning on the date that the First Milestone is achieved through the earlier of (A) 181 days following such date and (B) June 30, 2022; (iii) subject to the approval of the Company’s AXS-07 product candidate for the treatment of migraine (the “Second Milestone”), a third tranche consisting of additional term loans in an aggregate principal amount of up to $ 20.0 million, available at the Company’s option beginning on the date that the Second Milestone is achieved through the earlier of (A) 181 days following such date and (B) June 30, 2022; (iv) subject to the achievement of either the First Milestone or the Second Milestone and so long as the Company is in compliance with a required ratio of Lender indebtedness to net product revenue, a fourth tranche consisting of additional term loans in an aggregate principal amount of up to $ 60.0 million, available at the Company’s option beginning on January 1, 2022 and continuing through March 31, 2023; and (v) subject to approval by the Lenders’ in their discretion, a fifth tranche of additional term loans in an aggregate principal amount of up to $ 50.0 million, available through December 31, 2023. The remaining $ 10.0 million on the first tranche was not utilized and such tranche and future tranches were amended upon the execution of the First Amendment to the Loan and Security Agreement. See "First Amendment to the Loan and Security Agreement" below for further information. The Company intends to use the proceeds of the Term Loan Advances for working capital and general corporate purposes. In addition, approximately $ 21.7 million of the proceeds from the First Advance was used to satisfy in full and retire the Company’s indebtedness under the 2019 Term Loan (as defined below), as amended. The outstanding principal balance of the term loans bears interest at an annual rate equal to the greater of either (i) the prime rate as reported in The Wall Street Journal plus 5.90 % or (ii) 9.15 %, subject to an ability by the Company, during certain periods (each, a “PIK Deferral Period”), to request a reduction of the then-effective cash-pay interest rate by up to 1.00 % per annum (the “Cash Interest Reduction Amount”). Accrued interest is payable monthly following the funding of each term loan. During each PIK Deferral Period, the term loans will bear cash-pay interest, at the reduced amount, and will accrue paid-in-kind interest at a rate equal to the Cash Interest Reduction Amount multiplied by 1.15 , which amount will be capitalized and added to the outstanding principal balance of the term loans on each monthly interest payment date during the PIK Deferral Period.‌ The Company is required to repay the term loans in equal installments of principal and interest commencing on May 1, 2023 through October 1, 2025 (the “Maturity Date”). However, if either the First Milestone or the Second Milestone are achieved prior to May 1, 2023, and no default exists, the amortization commencement date will be automatically extended to November 1, 2023; if both the First Milestone and the Second Milestone are achieved prior to November 1, 2023, and no default exists, the amortization commencement date will be further automatically extended to May 1, 2024 and if any term loans are funded under the fourth tranche noted above prior to May 1, 2024, and no default exists, the amortization commencement date will be further automatically extended to November 1, 2024. On the Maturity Date, all unpaid term loans will be due and payable. As collateral for the obligations, the Company has granted to Hercules a senior security interest in all of Company’s right, title, and interest in, to and under all of Company’s property, inclusive of intellectual property, which includes one of the Company’s existing license agreements (the “License Agreement”) with Antecip Bioventures II LLC (“Antecip”), an entity owned by Axsome’s Chief Executive Officer and Chairman of the Board, Herriot Tabuteau, M.D., subject to limited exceptions . Antecip consented to the collateral assignment of the License Agreement, among other things, under a direct agreement (the “Direct Agreement”) with the Company and Hercules. The Loan Agreement contains customary representations, warranties and covenants, including covenants by the Company limiting additional indebtedness, liens (including a negative pledge on intellectual property and other assets), guaranties, mergers and consolidations, substantial asset sales, investments and loans, certain corporate changes, transactions with affiliates and fundamental changes. At the initial closing, there were no applicable financial covenants contained in the Loan Agreement. Only after additional amounts are drawn down by the Company in the future, if the Company decides to do so, under the terms set forth in the Loan Agreement, there will be certain limited financial covenants that will apply, including: • Effective upon the date the outstanding principal amount of the advances under the Loan Agreement equals or exceeds $ 55.0 million, which has not yet occurred, the Company at all times thereafter must maintain cash in an account or accounts in which Hercules has a first priority security interest, in an aggregate amount greater than or equal to $ 15.0 million, plus the amount of the Company’s accounts payable under U.S. GAAP not paid after the 180 th day following the invoice for such account payable (such amount, the “Qualified Cash A/P Amount”). • Effective upon the later of (i) the last calendar month of the calendar quarter that is twelve months following the earlier of (x) the date that the First Milestone is achieved and (y) the date that the Second Milestone is achieved, or (ii) the date on which the outstanding principal amount of the term loan advances under the Loan Agreement is equal to or greater than $ 65.0 million, neither of which have occurred yet, the Company is required to (A) ensure that at all times its market capitalization exceeds $ 2.0 billion, and that it maintains cash in an account which Hercules has a first priority security interest in an amount not less than 65 % of the sum of the outstanding principal amount of the term loan advances plus the Qualified Cash A/P Amount, (B) ensure that at all times that it maintains cash in an account which Hercules has a first priority security interest in an amount not less than 100 % of the sum of the outstanding principal amount of the term loan advances plus the Qualified Cash A/P Amount, or (C) achieve at least 60 % of the net product revenue per the board of directors approved forecast solely from the sale of AXS-05 and AXS-07 (which may include royalty, profit sharing, or sales-based milestone revenue recognized in accordance with GAAP, but will not include any upfront or non-sales-based milestone payments under business development or licensing transactions), measured on a trailing six-month basis as of the date of the Company’s most recent quarterly financial statement, determined on a quarterly basis. • Restrictions on the Company’s ability to incur additional indebtedness, pay dividends, encumber its intellectual property, or engage in certain fundamental business transactions, such as mergers or acquisitions of other businesses, with certain exceptions. The Company’s obligations under the Loan Agreement are subject to acceleration upon the occurrence of specified events of default, including payment default, insolvency and a material adverse change in the Borrower’s business, operations or financial or other condition. In addition, the Company is required to pay a final payment fee equal to the greater of (A) $ 2,910,000 and (B) 4.85 % of the aggregate amount of all term loan advances minus the aggregate amount of repayments made. The final payment fee is being accreted and amortized into interest expense using the effective interest rate method over the term of the loan. The Company may, at its option prepay the term loans in full or in part, subject to a prepayment penalty equal to (i) 2.0 % of the principal amount prepaid if the prepayment occurs prior to the first anniversary of the Closing Date, (ii) 1.5 % of the principal amount prepaid if the prepayment occurs on or after the first anniversary and prior to the second anniversary of the Closing Date, and (iii) 1.0 % of the principal amount prepaid if the prepayment occurs on or after the second anniversary and prior to the third anniversary of the Closing Date. First Amendment to the Loan Agreement On October 14, 2021 ("First Amendment Closing Date"), the Company entered into the first amendment to the Loan Agreement (the “First Amendment to the Loan Agreement”). Under the First Amendment to the Loan Agreement, the First Amendment amended the terms of that certain Loan and Security Agreement, dated as of September 25, 2020, by and among the Company, Hercules and the Lenders (the “Loan Agreement”) to, among other things, (i) increase the aggregate principal amount of the loan, available at the Company’s option, from $ 225,000,000 to $ 300,000,000 , (ii) change the draw amounts and dates available in Tranche 2 through Tranche 5 including increasing the amount available under Tranche 2 subject to FDA approval of the Company’s AXS-05 product candidate for the treatment of major depressive disorder from $ 35,000,000 to $ 100,000,000 , maintaining the amount available under Tranche 3 subject to FDA approval of the Company’s AXS-07 product candidate for the acute treatment of migraine of $ 20,000,000 , reducing the amount under Tranche 4 available upon achievement of certain combined sales and outstanding debt criteria from $ 60,000,000 to $ 55,000,000 , and increasing the amount available under Tranche 5 to support future strategic initiatives, including further pipeline advancement or expansion from $ 50,000,000 to $ 75,000,000 subject to the approval from Hercules, (iii) extend the maturity date of the facility from the original October 2025 to October 2026 , and optionally to October 2027 , subject to certain conditions, (iv) reset and extend the interest only period from the initial 30 months from the original loan closing to 48 months from the First Amendment and extendable up to 60 months subject to FDA approval of the Company’s AXS-05 product candidate for the treatment of major depressive disorder and subject to FDA approval of AXS-07 in the acute treatment of migraine, and (v) decrease the interest rate from 9.15 % (floating rate based on the greater of (a) 9.15 % or (b) US WSJ Prime + 5.90 %) to 8.95 % (floating rate based on the greater of (a) 8.95 % or (b) US WSJ Prime + 5.70 %). In addition, the Company is required to pay a final payment fee equal to (A) $ 2,910,000 plus (B) 4.5 % of the aggregate amount of all term future loan advances. The final payment fee is being accreted and amortized into interest expense using the effective interest rate method over the term of the loan. The Company may, at its option prepay the term loans in full or in part, subject to a prepayment penalty equal to (i) 2.0 % of the principal amount prepaid if the prepayment occurs prior to the first anniversary of the First Amendment Closing Date, (ii) 1.5 % of the principal amount prepaid if the prepayment occurs on or after the first anniversary and prior to the second anniversary of the First Amendment Closing Date, and (iii) 1.0 % of the principal amount prepaid if the prepayment occurs on or after the second anniversary and prior to the third anniversary of the First Amendment Closing Date. These percentages are unchanged from the Loan Agreement. Second Amendment to the Loan Agreement On March 27, 2022, the Company entered into the Second Amendment to the Loan Agreement subject to the closing of the Sunosi® Acquisition. See Note 1 - Nature of Business and Basis of Presentation for more detail. Loan Interest Expense and Amortization The Company incurred interest expense of $ 1,123,958 for the three months ended March 31, 2022 and $ 1,143,750 for the three months ended March 31, 2021 , respectively. In addition, amortization of the final payment fee was $ 97,860 for the three months ended March 31, 2022 and $ 143,589 for the three months ended March 31, 2021 , respectively. Amortization of the debt discount in relation to warrants and debt issuance costs was $ 125,497 for the three months ended March 31, 2022 and $ 132,508 for the three months ended March 31, 2021, respectively. The outstanding debt and unamortized debt discount balances are as follows: ​ March 31, December 31, Total Outstanding Debt $ 50,000,000 $ 50,000,000 Add: accreted liability of final payment fee 804,053 706,407 Less: unamortized debt discount, long-term ( 1,491,388 ) ( 1,616,885 ) Less: current portion of long-term debt — — Loan payable, long-term $ 49,312,665 $ 49,089,522 In connection with the entry into the Hercules Term Loan, the Company issued to Hercules a warrant to purchase a number of shares of the Company’s common stock equal to 2.5 % of the aggregate amount of the Term Loan Advances that are funded. Further information on warrants issued related to this loan and prior debt financings and amendments are disclosed in Note 7 - Stockholders’ Equity under the “Warrants” section. Scheduled Principal Payments on Outstanding Debt, as of March 31, 2022, are as follows: 2022 — 2023 — 2024 — 2025 8,026,818 2026 41,973,182 Total principal payments outstanding $ 50,000,000 The Company was in compliance with all covenants and requirements of its financing arrangements as of and during the three months ended March 31, 2022 .

Net Loss per Common Share

Net Loss per Common Share	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Net Loss per Common Share	Note 5. Net Loss per Common Share The following table sets forth the computation of basic and diluted net loss per common share: Three Months Ended March 31, 2022 2022 2021 Basic and diluted net loss per common share: Net loss $ ( 39,632,311 ) $ ( 29,259,970 ) Weighted average common shares outstanding—basic 38,323,167 37,429,450 Net loss per common share—basic and diluted $ ( 1.03 ) $ ( 0.78 ) The following potentially dilutive securities outstanding at March 31, 2022 and 2021 have been excluded from the computation of diluted weighted average shares outstanding, as they would be anti-dilutive: March 31, 2022 2021 Stock options 6,219,030 4,385,598 Restricted stock units 667,366 303,983 Warrants 15,541 15,541 Total 6,901,937 4,705,122

Commitments and Contingencies

Commitments and Contingencies	3 Months Ended
	Mar. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Note 6. Commitments and Contingencies Operating Leases For the three months ended March 31, 2022 and 2021, the Company had the following operating lease expense: Statement of Operations Location Three Months Ended March 31, 2022 Three Months Ended March 31, 2021 Operating lease expense General and administrative $ 290,769 $ 286,923 Total operating lease expense $ 290,769 $ 286,923 Future minimum lease payments of the Company’s operating leases as of March 31, 2022 were as follows: 2022 $ 885,000 2023 105,000 2024 — 2025 — Thereafter — Total lease payments 990,000 Less imputed interest ( 22,752 ) Present value of operating lease liabilities $ 967,248 In January 2022, the Company entered into an agreement to extend the lease of 22 Cortlandt Street for a term of six months from August 1, 2022 through January 31, 2023. As of March 31, 2022 , the remaining lease term for our operating lease was 0.8 years with a discount rate of 6.0 %. The interest rate implicit in lease contracts is typically not readily determinable and as such, the Company uses its incremental borrowing rate based on the information available at the lease commencement date, which represents an internally developed rate that would be incurred to borrow, on a collateralized basis, over a similar term, an amount equal to the lease payments in a similar economic environment.

Stockholders' Equity

Stockholders' Equity	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Stockholders' Equity	Note 7. Stockholders’ Equity Capital Structure In December 2019, the Company entered into the December 2019 Sales Agreement with SVB Leerink, pursuant to which the Company may sell up to $ 80 million in shares of the Company’s common stock from time to time through SVB Leerink, acting as the Company’s sales agent, in one or more at-the-market offerings utilizing the 2019 Shelf Registration Statement. SVB Leerink is entitled to receive a commission of 3.0 % of the gross proceeds for any shares sold under the December 2019 Sales Agreement. The December 2019 Sales Agreement was replaced by the March 2022 Sales Agreement (see below). In March 2022, the Company entered into the March 2022 Sales Agreement with SVB Leerink, pursuant to which the Company may sell up to $ 200 million in shares of the Company’s common stock from time to time through SVB Leerink, acting as the Company’s sales agent, in one or more at-the-market offerings utilizing the 2019 Shelf Registration Statement. SVB Leerink is entitled to receive a commission of 3.0 % of the gross proceeds for any shares sold under the March 2022 Sales Agreement. The March 2022 Sales Agreement supersedes the December 2019 Sales Agreement, dated December 5, 2019, by and between the Company and SVB Leerink LLC. Under the December 2019 Sales Agreement and March 2022 Sales Agreement, for the three months ended March 31, 2022 , the Company received approximately $ 32.0 million in gross proceeds through the sale of 1,044,081 shares, of which net proceeds were approximately $ 31.0 million. The holders of shares of common stock are entitled to one vote for each share of common stock held at all meetings of stockholders and written actions in lieu of meetings. The holders of shares of common stock are entitled to receive dividends, if and when declared by the board of directors. Shelf Registration Statement On December 5, 2019, the Company filed an automatic shelf registration statement (“2019 Shelf Registration”) with the Securities and Exchange Commission (“SEC”) for the issuance of common stock, preferred stock, warrants, rights, debt securities and units. It became effective upon filing with the SEC and is currently the Company’s only active shelf registration. Through the date of this report, the Company has issued common stock of approximately $ 261.2 million pursuant to such shelf registration statement. Under SEC rules, the 2019 Shelf Registration Statement allows for the potential future offer and sale by the Company, from time to time, in one or more public offerings, of an indeterminate amount of the Company’s common stock, preferred stock, debt securities, and units at indeterminate prices. At the time any of the securities covered by the 2019 Shelf Registration Statement are offered for sale, a prospectus supplement will be prepared and filed with the SEC containing specific information about the terms of any such offering. Equity Incentive Plans There were 2,187,058 shares available for the issuance of stock options or stock-based awards under the Company’s 2015 Omnibus Incentive Compensation Plan at March 31, 2022. Stock Options The following table sets forth the stock option activity for the three months ended March 31, 2022: ​Number ​Weighted Weighted ​Aggregate Outstanding at December 31, 2021 5,090,377 $ 28.89 Granted 1,223,019 30.05 Exercised ( 18,015 ) 10.08 Forfeited ( 67,139 ) 43.83 Expired ( 9,212 ) 53.10 Outstanding at March 31, 2022 6,219,030 $ 28.98 7.6 $ 106,188,389 Vested and expected to vest at March 31, 2022 6,219,030 $ 28.98 7.6 $ 106,188,389 Exercisable at March 31, 2022 2,932,835 $ 15.85 5.7 $ 82,434,018 The fair value of each stock option grant is estimated on the date of grant using the Black-Scholes option pricing model. The expected term of the Company’s stock options has been determined utilizing the “simplified” method as described in the SEC’s Staff Accounting Bulletin No. 107 relating to stock-based compensation. The simplified method was chosen because the Company has limited historical option exercise experience due to its short operating history. The risk-free interest rate is based on the U.S. Treasury yield in effect at the time of grant for a period approximately equal to the expected term of the award. Expected dividend yield is based on the fact that the Company has never paid cash dividends and does not expect to pay any cash dividends in the foreseeable future. Expected volatility is based on historical volatilities of similar entities within the Company’s industry which were commensurate with the Company’s expected term assumption. The weighted average grant date fair value of options granted was $ 21.00 per option for the three months ended March 31, 2022. As of March 31, 2022 , there was $ 91.0 million of total unrecognized compensation cost related to non-vested stock options which is expected to be recognized over a weighted average period of 3.3 years. These amounts do not include 6,169 options outstanding as of March 31, 2022, which are performance-based and vest upon the achievement of certain corporate milestones. Stock‑based compensation will be measured and recorded if and when it is probable that the milestone will occur. Restricted Stock Units In 2020, the Company began granting RSUs covering an equal number of its shares of common stock to employees. The fair value of RSUs is determined on the date of the grant based on the market price of its shares of common stock as of that date. The fair value of the RSUs is recognized as an expense ratably over the vesting period of four years . As of March 31, 2022 , total compensation cost not yet recognized related to unvested RSUs was $ 19.5 million, which is expected to be recognized over a weighted-average period of 3.6 years. The following table sets forth the RSU activity for the three months ended March 31, 2022: ​ Number Weighted Outstanding at December 31, 2021 302,764 $ 42.93 Granted 429,902 23.27 Vested ( 61,581 ) 41.49 Forfeited ( 3,719 ) 48.73 Outstanding at March 31, 2022 667,366 $ 30.36 Stock-based compensation expense recognized for the three months ended March 31, 2022 and 2021 was allocated as follows: ​ Three Months Ended March 31, ​ 2022 2021 Research and development $ 1,809,477 $ 1,534,395 General and administrative 5,788,852 2,196,702 Total $ 7,598,329 $ 3,731,097 Warrants The following table summarizes warrant activity for the three months ended March 31, 2022: Weighted average Warrants exercise price Outstanding at December 31, 2021 15,541 $ 80.43 Issued — — Exercised — — Outstanding at March 31, 2022 15,541 $ 80.43 Outstanding Warrants In connection with the first advance of the 2020 Term Loan, Hercules Capital Inc. received warrants to purchase an aggregate 15,541 shares of the Company’s common stock at an exercise price of $ 80.43 per share, which was the volume weighted average price of the Company’s common stock over the ten -day trading period immediately preceding the initial closing, subject to certain limited adjustments as specified in the warrant. The warrants are exercisable for seven years from the date of issuance. The warrants were classified as a component of stockholders’ equity. The relative fair value of the warrants of approximately $ 0.9 million at the time of issuance, which was determined using the Black-Scholes option-pricing model, was recorded as additional paid-in capital and reduced the carrying value of the debt. The discount on the debt is being amortized to interest expense over the term of the debt utilizing the effective interest rate method.

License Agreements

License Agreements	3 Months Ended
	Mar. 31, 2022
Research and Development [Abstract]
License Agreements	Note 8. License Agreements Exclusive License Agreement with Pfizer In January 2020, the Company entered into an exclusive license agreement with Pfizer Inc. (“Pfizer”) for Pfizer’s clinical and nonclinical data, and intellectual property for reboxetine, the active pharmaceutical ingredient in AXS-12 which the Company is developing for the treatment of narcolepsy. The agreement also provides the Company exclusive rights to develop and commercialize esreboxetine, a new late-stage product candidate referred to as AXS-14, in the U.S. for the treatment of fibromyalgia. Under the terms of the agreement, Pfizer received 82,019 shares of the Company’s common stock having a stated value of $ 8.0 million, based on the average closing price of the Company’s common stock for the ten prior trading days of $ 97.54 , in consideration for the license and rights and also received an upfront cash payment of $ 3.0 million. The Company determined that the fair value of each share of common stock granted to Pfizer on the closing date of January 9, 2020 was $ 87.24 , based on the closing price of the Company’s stock on that date. As a result, the fair value of the stock issued was $ 7.2 million and therefore, the total research and development expense recognized was $ 10.2 million related to the Pfizer license agreement during the year ended 2020. Pfizer can also receive up to $ 323 million in regulatory and sales milestones, and tiered mid-single to low double-digit royalties on future sales related to the licensed products. Pfizer will also have a right of first negotiation on any potential future strategic transactions involving AXS-12 and AXS-14. During the three months ended March 31, 2022 and 2021 , no milestone payments or royalties were paid to Pfizer by the Company. Exclusive License Agreements with Antecip In 2012, the Company entered into three exclusive license agreements with Antecip, in which it was granted exclusive licenses to develop, manufacture, and commercialize Antecip’s patents and applications related to the development of AXS-02, AXS-05, and AXS-04, anywhere in the world for human therapeutic, veterinary, and diagnostic use. Pursuant to the agreements, the Company is required to use commercially reasonable efforts to develop, obtain regulatory approval for and commercialize AXS-02, AXS-05, and AXS-04. Under the terms of the agreements, the Company is required to pay to Antecip a royalty equal to 4.5 % for AXS-02, 3.0 % for AXS-05, and 1.5 % for AXS-04, of net sales of products containing the licensed technology by the Company, its affiliates, or permitted sublicensees. These royalty payments are subject to reduction by an amount up to 50.0 % of any required payments to third parties. Unless earlier terminated by a party for cause or by the Company for convenience, the agreements shall remain in effect on a product-by-product and country-by-country basis until the later to occur of (i) the applicable product is no longer covered by a valid claim in that country or (ii) 10 years from the first commercial sale of the applicable product in that country. Upon expiration of the agreements with respect to a product in a country, the Company’s license grant for that product in that country will become a fully paid-up, royalty-free, perpetual non-exclusive license. If Antecip terminates any of the agreements for cause, or if the Company exercises its right to terminate any of the agreements for convenience, the rights granted to the Company under such terminated agreement will revert to Antecip. To date, the Company has not been required to make any payments to Antecip under any of the license agreements. In connection with the 2020 Term Loan, the Company entered into a Direct Agreement with Antecip pursuant to which Antecip consented to the collateral assignment of the License Agreement to Hercules, among other things.

Summary of Significant Accoun_2

Summary of Significant Accounting Policies (Policies)	3 Months Ended
	Mar. 31, 2022
Accounting Policies [Abstract]
Significant Risks And Uncertainties	Significant Risks and Uncertainties The Company’s operations are subject to a number of factors that can affect its operating results and financial condition. Such factors include, but are not limited to: the results of clinical testing and trial activities of the Company’s product candidates; the Company’s ability to obtain regulatory approval to market its products, if approved; competition from products manufactured and sold or being developed by other companies; the price of, and demand for, the Company’s products, if approved; the Company’s ability to negotiate favorable licensing or other manufacturing and marketing agreements for its products, if approved; and the Company’s ability to raise additional financing. If the Company does not successfully commercialize any of its product candidates, it will be unable to generate recurring product revenue or achieve and maintain profitability.
Use of Estimates	Use of Estimates Management considers many factors in developing the estimates and assumptions that are used in the preparation of these financial statements. Management must apply significant judgment in this process. In addition, other factors may affect estimates, including expected business and operational changes, sensitivity and volatility associated with the assumptions used in developing estimates, and whether historical trends are expected to be representative of future trends. The estimation process often may yield a range of potentially reasonable estimates of the ultimate future outcomes and management must select an amount that falls within that range of reasonable estimates. This process may result in actual results differing materially from those estimated amounts used in the preparation of the financial statements if these results differ from historical experience, or other assumptions do not turn out to be substantially accurate, even if such assumptions are reasonable when made. In preparing these financial statements, management used significant estimates in the following areas, among others: stock‑based compensation expense; the determination of the fair value of the warrants; the accounting for research and development costs; and the recoverability of the Company’s net deferred tax assets and related valuation allowance.
Foreign Currency Translation	Foreign Currency Translation Expenses denominated in foreign currency are translated into U.S. dollars at the exchange rate on the date the expense is incurred. Assets and liabilities of foreign operations are translated at period-end exchange rates. The effect of exchange rate fluctuations on translating foreign currency into U.S. dollars is included in the Statements of Operations and is not material to the Company’s financial statements.
Segment and Geographic Information	Segment and Geographic Information Operating segments are defined as components of an enterprise for which separate discrete information is available for evaluation by the chief operating decision maker or decision-making group, in deciding how to allocate resources and in assessing performance. The Company views its operations and manages its business as one operating segment, which is the business of developing novel therapies for the management of CNS disorders.
Cash Equivalents	Cash Equivalents The Company considers all highly liquid investments that have maturities of three months or less when acquired to be cash equivalents. The Company’s cash and cash equivalents includes holdings in checking and overnight sweep accounts. The Company’s cash equivalents, which are money market funds held in a sweep account, are measured at fair value on a recurring basis. As of March 31, 2022 , the balance of cash and cash equivalents was $ 84.7 million, which approximates fair value and was determined based upon Level 1 inputs. The sweep account is valued using quoted market prices with no valuation adjustments applied. Accordingly, these securities are categorized as Level 1.
Concentration of Credit Risk	Concentration of Credit Risk Financial instruments that potentially subject the Company to a concentration of credit risk consist of cash. The Company maintains its cash at financial institutions, which at times, exceed federally insured limits. At March 31, 2022 , the majority of the Company’s cash was held by one financial institution and the amount on deposit was in excess of Federal Deposit Insurance Corporation insurance limits. The Company has not recognized any losses from credit risks on such accounts since inception. The Company believes it is not exposed to significant credit risk on cash.
Fair Value of Financial Instruments	Fair Value of Financial Instruments Fair value is defined as the exchange price that would be received for an asset or paid to transfer a liability (an exit price) in the principal or most advantageous market for the asset or liability in an orderly transaction between market participants at the measurement date. Assets and liabilities that are measured at fair value are reported using a three‑level fair value hierarchy that prioritizes the inputs used to measure fair value. This hierarchy maximizes the use of observable inputs and minimizes the use of unobservable inputs. The three levels of inputs used to measure fair value are as follows: Level 1—Quoted prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date. Level 2—Inputs other than quoted prices in active markets that are observable for the asset or liability, either directly or indirectly. Level 3—Inputs that are unobservable for the asset or liability. To the extent that valuation is based on models or inputs that are less observable or unobservable in the market, the determination of fair value requires more judgment. Accordingly, the degree of judgment exercised by the Company in determining fair value is greatest for instruments categorized in Level 3. A financial instrument’s level within the fair value hierarchy is based on the lowest level of any input that is significant to the fair value measurement. The Company’s financial instruments are cash, accounts payable, accrued liabilities, and current and long-term debt. The carrying values for cash, accounts payable and accrued liabilities reported in the accompanying consolidated financial statements approximate their respective fair values due to their short-term maturities. The carrying value of debt on the Company’s balance sheet (see Note 6 – Loan and Security Agreement), is estimated to approximate its fair value as the interest rate approximates the market rate for loans with similar terms and risk characteristics.
Debt Issuance Costs	Debt Issuance Costs Debt issuance costs consist of costs incurred in obtaining long-term financing. These costs are classified on the consolidated balance sheet as a direct deduction from the carrying amount of the related debt liability. These expenses are deferred and amortized as part of interest expense in the consolidated statement of operations using the effective interest rate method over the term of the debt agreement.
Equipment	Equipment Equipment consists primarily of computer equipment and is recorded at cost. Equipment is depreciated on a straight‑line basis over its estimated useful life, which the Company estimates to be three years . When equipment is sold or otherwise disposed of, the cost and related accumulated depreciation are removed from the accounts and the resulting gain or loss is included in operating expenses.
Research and Development Costs	Research and Development Costs Research and development costs are expensed as incurred. Research and development expenses consist primarily of employee-related expenses including salaries, benefits, travel, and stock‑based compensation expense, contract services, costs incurred to third-party service providers for the conduct of research, preclinical and clinical studies, laboratory supplies, product license fees, consulting and other related expenses. We estimate research, preclinical and clinical study expenses based on services performed, pursuant to contracts with third-party research and development organizations that conduct and manage research, preclinical and clinical activities on our behalf. We estimate these expenses based on discussions with internal management personnel and external service providers as to the progress or stage of completion of services and the contracted fees to be paid for such services. If the actual timing of the performance of services or the level of effort varies from the original estimates, we will adjust the accrual accordingly. Payments associated with licensing agreements to acquire licenses to develop, use, manufacture and commercialize products that have not reached technological feasibility and do not have alternative future use are expensed as incurred. Payments made to third parties under these arrangements in advance of the performance of the related services by the third parties are recorded as prepaid expenses until the services are rendered.
Income Taxes	Income Taxes Income taxes are accounted for under the asset and liability method. Under this method, deferred tax assets and liabilities are recognized for the future tax consequences attributable to the differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases, operating losses, and tax credit carryforwards. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect of a change in tax rates on deferred tax assets and liabilities is recognized in income in the period that includes the enactment date. Valuation allowances are provided if, based upon the weight of available evidence, it is more likely than not that some or all of the deferred tax assets will not be realized. The Company estimates an annual effective tax rate of 0 % for the year ending December 31, 2022 and has no t recorded an income tax benefit for the three months ended March 31, 2022 and 2021 since it determined that a full valuation allowance is required against the Company’s deferred tax assets. The Company recognizes the tax benefit from an uncertain tax position only if it is more likely than not to be sustained upon examination based on the technical merits of the position as well as consideration of the available facts and circumstances. When uncertain tax positions exist, the Company recognizes the tax benefit of tax positions to the extent that the benefit will more likely than not be realized. As of March 31, 2022 , the Company does not believe any material uncertain tax positions are present. In the event the Company determines that accrual of interest or penalties are necessary in the future, the amount will be presented as a component of income tax expense.
Stock Based Compensation	Stock-Based Compensation For stock options issued, the Company estimates the grant date fair value of each option using the Black‑Scholes option pricing model. The Black-Scholes model takes into account the expected volatility of the Company’s common stock, the risk-free interest rate, the estimated life of the option, the closing market price of the Company’s common stock and the exercise price. The estimates utilized in the Black-Scholes calculation involve inherent uncertainties and the application of management’s judgment. In addition, the Company recognizes expense for equity award forfeitures as they occur. For restricted stock units (“RSUs”), the Company issues them in the form of Company common stock. The fair market value of these awards is based on the market closing price per share on the grant date. For awards subject to service-based vesting conditions, the Company recognizes stock-based compensation expense on a straight-line basis over the requisite service period, which is generally the vesting term. For awards subject to performance-based vesting conditions, the Company recognizes stock-based compensation expense using the accelerated attribution method when it is probable that the performance condition will be achieved. The expense related to the stock-based compensation is recorded within the same financial statement line item as the grantee’s cash compensation. The Company’s policy upon exercise of stock options and RSUs is that shares will be issued as new shares drawing on the Company’s 2015 Omnibus Incentive Compensation Plan share pool that was adopted by the stockholders in November 2015.
Basic and Diluted Net Loss per Common Share	Basic and Diluted Net Loss per Common Share Basic net loss per share of common stock is computed by dividing net loss by the weighted average number of shares of common stock outstanding during the period. Diluted net loss per share of common stock includes the effect, if any, from the potential exercise or conversion of securities, such as warrants, stock options, and RSUs, which would result in the issuance of incremental shares of common stock. As the impact of these items is anti-dilutive during periods of net loss, there was no difference between basic and diluted net loss per share of common stock for the three months ended March 31, 2022 and 2021 .
Leases	Leases The Company determines if an arrangement is a lease at contract inception. Operating lease assets represent the Company’s right to use an underlying asset for the lease term and operating lease liabilities represent the Company’s obligation to make lease payments arising from the lease. When evaluating whether a contract contains a lease, the Company considers whether (1) the contract explicitly or implicitly identifies assets that are contractually defined and (2) the Company obtains substantially all of the economic benefits from the use of that underlying asset and directs how and for what purpose the asset is used during the term of the contract. The Company’s lease agreement contains lease and non-lease components. Non-lease components primarily include payments for maintenance and utilities. The Company has applied the practical expedient to combine fixed payments for non-lease components with lease payments and account for them together as a single lease component, which increases the amount of lease assets and corresponding liabilities. Payments under the Company’s lease arrangement are primarily fixed, however variable payments, are expensed as incurred and not included in the operating lease asset and liability. Operating lease assets and liabilities are recognized at the commencement date of the lease based upon the present value of lease payments over the lease term. When determining the lease term, the Company includes options to extend or terminate the lease when it is reasonably certain that the Company will exercise that option. The Company uses the implicit interest rate when readily determinable and uses the Company’s incremental borrowing rate when the implicit rate is not readily determinable based upon the information available at the commencement date in determining the present value of the lease payments. The Company’s operating leases are reflected in the right-of-use operating asset; operating lease liability, current portion; and operating lease liability, long-term portion in the Company’s consolidated balance sheets. Lease expense for minimum lease payments is recognized on a straight-line basis over the lease term. Short-term leases, defined as leases that have a lease term of 12 months or less at the commencement date, and do not include an option to extend the term or purchase the underlying asset that the Company is reasonably certain to exercise, are excluded from this treatment and are recognized on a straight-line basis over the term of the lease.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In October 2021, the Financial Accounting Standards Board (“FASB”) issued Accounting Standards Update (“ASU”) No. 2021-08, Business Combinations (Topic 805) . This update requires that an entity (acquirer) recognize and measure contract assets and contract liabilities acquired in a business combination in accordance with Accounting Standards Codification (“ASC”) 606. This differs from the current requirement to measure contract assets and contract liabilities acquired in a business combination at fair value. The amendments in this update should be applied prospectively, and are effective for fiscal years beginning after December 15, 2022, including interim periods within those fiscal years. Early adoption is permitted, including adoption in an interim period. The Company is currently evaluating the impact of this ASU on its consolidated financial statements.

Accrued Expenses and Other Cu_2

Accrued Expenses and Other Current Liabilities (Tables)	3 Months Ended
	Mar. 31, 2022
Accrued Liabilities and Other Liabilities [Abstract]
Schedule of Accrued Expenses	At March 31, 2022 and December 31, 2021 accrued expenses and other current liabilities consisted of the following: ​ March 31, December 31, Accrued research and development $ 2,726,847 $ 2,416,897 Accrued compensation 2,013,040 4,050,236 Accrued general and administrative 5,856,779 2,442,700 Accrued Interest 390,556 385,347 Total $ 10,987,222 $ 9,295,180

Loan and Security Agreement (Ta

Loan and Security Agreement (Tables)	3 Months Ended
	Mar. 31, 2022
Debt Disclosure [Abstract]
Schedule of Outstanding Debt and Unamortized Debt Discount Balances	The outstanding debt and unamortized debt discount balances are as follows: ​ March 31, December 31, Total Outstanding Debt $ 50,000,000 $ 50,000,000 Add: accreted liability of final payment fee 804,053 706,407 Less: unamortized debt discount, long-term ( 1,491,388 ) ( 1,616,885 ) Less: current portion of long-term debt — — Loan payable, long-term $ 49,312,665 $ 49,089,522
Schedule of Principal Payments	Scheduled Principal Payments on Outstanding Debt, as of March 31, 2022, are as follows: 2022 — 2023 — 2024 — 2025 8,026,818 2026 41,973,182 Total principal payments outstanding $ 50,000,000

Net Loss per Common Share (Tabl

Net Loss per Common Share (Tables)	3 Months Ended
	Mar. 31, 2022
Earnings Per Share [Abstract]
Computation of Basic and Diluted Net Loss per Common Share	The following table sets forth the computation of basic and diluted net loss per common share: Three Months Ended March 31, 2022 2022 2021 Basic and diluted net loss per common share: Net loss $ ( 39,632,311 ) $ ( 29,259,970 ) Weighted average common shares outstanding—basic 38,323,167 37,429,450 Net loss per common share—basic and diluted $ ( 1.03 ) $ ( 0.78 )
Schedule of Potentially Dilutive Securities	The following potentially dilutive securities outstanding at March 31, 2022 and 2021 have been excluded from the computation of diluted weighted average shares outstanding, as they would be anti-dilutive: March 31, 2022 2021 Stock options 6,219,030 4,385,598 Restricted stock units 667,366 303,983 Warrants 15,541 15,541 Total 6,901,937 4,705,122

Commitments and Contingencies (

Commitments and Contingencies (Tables)	3 Months Ended
	Mar. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Schedule of Operating Lease Expense	For the three months ended March 31, 2022 and 2021, the Company had the following operating lease expense: Statement of Operations Location Three Months Ended March 31, 2022 Three Months Ended March 31, 2021 Operating lease expense General and administrative $ 290,769 $ 286,923 Total operating lease expense $ 290,769 $ 286,923
Schedule of Future Minimum Lease Payments of Operating Leases	Future minimum lease payments of the Company’s operating leases as of March 31, 2022 were as follows: 2022 $ 885,000 2023 105,000 2024 — 2025 — Thereafter — Total lease payments 990,000 Less imputed interest ( 22,752 ) Present value of operating lease liabilities $ 967,248

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	3 Months Ended
	Mar. 31, 2022
Equity [Abstract]
Summary of Stock Option Activity	The following table sets forth the stock option activity for the three months ended March 31, 2022: ​Number ​Weighted Weighted ​Aggregate Outstanding at December 31, 2021 5,090,377 $ 28.89 Granted 1,223,019 30.05 Exercised ( 18,015 ) 10.08 Forfeited ( 67,139 ) 43.83 Expired ( 9,212 ) 53.10 Outstanding at March 31, 2022 6,219,030 $ 28.98 7.6 $ 106,188,389 Vested and expected to vest at March 31, 2022 6,219,030 $ 28.98 7.6 $ 106,188,389 Exercisable at March 31, 2022 2,932,835 $ 15.85 5.7 $ 82,434,018
Schedule of RSU Activity	The following table sets forth the RSU activity for the three months ended March 31, 2022: ​ Number Weighted Outstanding at December 31, 2021 302,764 $ 42.93 Granted 429,902 23.27 Vested ( 61,581 ) 41.49 Forfeited ( 3,719 ) 48.73 Outstanding at March 31, 2022 667,366 $ 30.36
Schedule of Stock-Based Compensation Expense Recognized	Stock-based compensation expense recognized for the three months ended March 31, 2022 and 2021 was allocated as follows: ​ Three Months Ended March 31, ​ 2022 2021 Research and development $ 1,809,477 $ 1,534,395 General and administrative 5,788,852 2,196,702 Total $ 7,598,329 $ 3,731,097
Schedule of Warrant Activity	The following table summarizes warrant activity for the three months ended March 31, 2022: Weighted average Warrants exercise price Outstanding at December 31, 2021 15,541 $ 80.43 Issued — — Exercised — — Outstanding at March 31, 2022 15,541 $ 80.43

Nature of Business and Basis _2

Nature of Business and Basis of Presentation - Additional Information (Details)	Mar. 25, 2022USD ($)Market	Mar. 31, 2022USD ($)Product	Mar. 27, 2022USD ($)$ / shares	Dec. 31, 2021USD ($)	Oct. 14, 2021USD ($)	Sep. 30, 2020USD ($)
Debt Instrument [Line Items]
Number of late-stage candidates in Company's product candidate portfolio | Product		4
Accumulated deficit		$ 448,831,396		$ 409,199,085
Share price not less than three day volume weighted average share price discount rate | $ / shares			$ 20
Maximum
Debt Instrument [Line Items]
Unregistered common stock value			$ 8,000,000
Minimum
Debt Instrument [Line Items]
Unregistered common stock value			5,000,000
Term Loan | Hercules Capital Inc
Debt Instrument [Line Items]
Line of credit	$ 300,000,000
Term loan 2020 tranche one
Debt Instrument [Line Items]
Maximum loan amount			95,000,000			$ 60,000,000
Term loan 2020 tranche one | Second Amendment To Loan and Security Agreement
Debt Instrument [Line Items]
Maximum loan amount			45,000,000
Tranche Two Sub-Tranche One
Debt Instrument [Line Items]
Maximum loan amount			35,000,000		$ 50,000,000
Tranche Two Sub-Tranche Two
Debt Instrument [Line Items]
Maximum loan amount			35,000,000		50,000,000
Tranche Two Sub-Tranche Three
Debt Instrument [Line Items]
Maximum loan amount			30,000,000
Term loan 2020 tranche three
Debt Instrument [Line Items]
Maximum loan amount					20,000,000	20,000,000
Tranche Three Sub Tranche One
Debt Instrument [Line Items]
Maximum loan amount			15,000,000
Tranche Three Sub Tranche Two
Debt Instrument [Line Items]
Maximum loan amount			5,000,000
Term loan 2020 tranche four
Debt Instrument [Line Items]
Maximum loan amount			50,000,000		55,000,000	60,000,000
Term loan 2020 tranche five
Debt Instrument [Line Items]
Maximum loan amount			$ 35,000,000		$ 75,000,000	$ 50,000,000
Sunosi
Debt Instrument [Line Items]
Revenue milestones	165,000,000
Development milestones	1,000,000
Jazz Pharmaceuticals Plc | Sunosi
Debt Instrument [Line Items]
Upfront payment	$ 53,000,000
Number of Asian markets | Market	12

Summary of Significant Accoun_3

Summary of Significant Accounting Policies - Additional Information (Details)	1 Months Ended	3 Months Ended
	Dec. 31, 2022	Mar. 31, 2022USD ($)InstitutionSegment	Mar. 31, 2021USD ($)
Segment and Geographic Information
Number of operating segments | Segment		1
Cash Equivalents
Cash Equivalents		$ 84,700,000
Concentration of Credit Risk
Number of financial institutions that hold the Company's cash | Institution		1
Equipment
Estimated useful life		3 years
Income Taxes
Income tax benefit		$ 0	$ 0
Forecast
Income Taxes
Effective tax rate	0.00%

Accrued Expenses and Other Cu_3

Accrued Expenses and Other Current Liabilities - Schedule of Accrued Expenses (Details) - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Accrued Liabilities and Other Liabilities [Abstract]
Accrued research and development	$ 2,726,847	$ 2,416,897
Accrued compensation	2,013,040	4,050,236
Accrued general and administrative	5,856,779	2,442,700
Accrued Interest	390,556	385,347
Total	$ 10,987,222	$ 9,295,180

Loan and Security Agreement - A

Loan and Security Agreement - Additional Information (Details) - USD ($)	Oct. 14, 2021	Sep. 30, 2020	Mar. 31, 2022	Mar. 31, 2021	Mar. 27, 2022
Line Of Credit Facility [Line Items]
Interest expense			$ 1,123,958	$ 1,143,750
Amortization of debt issuance costs			97,860	143,589
Amortization of debt discount			$ 223,143	276,095
Warrants
Line Of Credit Facility [Line Items]
Percentage of aggregate amount of loan			2.50%
Amortization of debt discount			$ 125,497	$ 132,508
Term Loan 2020
Line Of Credit Facility [Line Items]
Maximum loan amount	$ 300,000,000
First advance used to repay previous debt		$ 21,700,000
Debt instrument maturity, month and year		2025-10
Debt instrument, interest payment period	48 months	30 months
Base interest rate	8.95%	9.15%
Cash pay interest rate		1.00%
Cash pay interest multiplier		1.15
Final payment fee	$ 2,910,000	$ 2,910,000
Percentage of final payment fee	4.50%	4.85%
Term Loan 2020 | Minimum
Line Of Credit Facility [Line Items]
Debt instrument maturity, month and year	2026-10
Term Loan 2020 | Maximum
Line Of Credit Facility [Line Items]
Debt instrument maturity, month and year	2027-10
Term Loan 2020 | Prime Rate
Line Of Credit Facility [Line Items]
Interest rate basis	5.70%	5.90%
Term Loan 2020 | Subject to FDA Approval of AXS-05 and AXS-07 | Maximum
Line Of Credit Facility [Line Items]
Debt instrument, interest payment period	60 months
Term Loan 2020 | Prepayment Occurs Prior to First Anniversary of Closing Date
Line Of Credit Facility [Line Items]
Maximum loan amount		$ 225,000,000
Percentage of prepayment penalty		2.00%
Term Loan 2020 | Outstanding principle and advances under the loans agreement exceeds 55 million
Line Of Credit Facility [Line Items]
Minimum cash to be maintain as a first priority security interest		$ 15,000,000
Period of unpaid invoices amount maintain as security		180 days
Term Loan 2020 | Outstanding principle and advances under the loans agreement exceeds 55 million | Minimum
Line Of Credit Facility [Line Items]
Outstanding amount		$ 55,000,000
Term Loan 2020 | Outstanding principle and advances under the loans agreement exceeds 65 million
Line Of Credit Facility [Line Items]
Minimum amount of market capital to be maintained		$ 2,000,000,000
Minimum percentage of cash to be maintained as a security following market capitalization condition		65.00%
Minimum percentage of cash to be maintained as a security		100.00%
Term Loan 2020 | Outstanding principle and advances under the loans agreement exceeds 65 million | AXS-05 and AXS-07
Line Of Credit Facility [Line Items]
Minimum product revenue percent		60.00%
Term Loan 2020 | Outstanding principle and advances under the loans agreement exceeds 65 million | Minimum
Line Of Credit Facility [Line Items]
Outstanding amount		$ 65,000,000
Term Loan 2020 | Prepayment Occurs on or After First Anniversary and Prior to Second Anniversary of the Closing Date
Line Of Credit Facility [Line Items]
Percentage of prepayment penalty		1.50%
Term Loan 2020 | Prepayment Occurs on or After Second Anniversary and Prior to Third Anniversary of Closing Date
Line Of Credit Facility [Line Items]
Percentage of prepayment penalty		1.00%
Term Loan 2020 | Prepayment Occurs Prior to First Anniversary of First Amendment Closing Date
Line Of Credit Facility [Line Items]
Percentage of prepayment penalty	2.00%
Term Loan 2020 | Prepayment Occurs on or After First Anniversary and Prior to Second Anniversary of First Amendment Closing Date
Line Of Credit Facility [Line Items]
Percentage of prepayment penalty	1.50%
Term Loan 2020 | Prepayment Occurs on or After Second Anniversary and Prior to Third Anniversary of First Amendment Closing Date
Line Of Credit Facility [Line Items]
Percentage of prepayment penalty	1.00%
Term loan 2020 tranche one
Line Of Credit Facility [Line Items]
Maximum loan amount		$ 60,000,000			$ 95,000,000
Proceeds from debt		50,000,000
Remaining credit facility to be drawn	$ 10,000,000	10,000,000
Term loan 2020 tranche two
Line Of Credit Facility [Line Items]
Maximum loan amount	100,000,000	$ 35,000,000
Period to achieve first milestone		181 days
Term loan 2020 tranche three
Line Of Credit Facility [Line Items]
Maximum loan amount	20,000,000	$ 20,000,000
Period to achieve second milestone		181 days
Term loan 2020 tranche four
Line Of Credit Facility [Line Items]
Maximum loan amount	55,000,000	$ 60,000,000			50,000,000
Term loan 2020 tranche five
Line Of Credit Facility [Line Items]
Maximum loan amount	$ 75,000,000	$ 50,000,000			$ 35,000,000

Loan and Security Agreement - S

Loan and Security Agreement - Schedule of Outstanding Debt and Unamortized Debt Discount Balances (Details) - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
Total Outstanding Debt	$ 50,000,000	$ 50,000,000
Add: accreted liability of final payment fee	804,053	706,407
Less: unamortized debt discount, long-term	(1,491,388)	(1,616,885)
Loan payable, long-term	$ 49,312,665	$ 49,089,522

Loan and Security Agreement -_2

Loan and Security Agreement - Schedule of Principal Payments (Details) - USD ($)	Mar. 31, 2022	Dec. 31, 2021
Debt Disclosure [Abstract]
2025	$ 8,026,818
2026	41,973,182
Total principal payments outstanding	$ 50,000,000	$ 50,000,000

Net Loss per Common Share - Com

Net Loss per Common Share - Computation of Basic and Diluted Net Loss per Common Share (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Basic and diluted net loss per common share:
Net loss	$ (39,632,311)	$ (29,259,970)
Weighted average common shares outstanding, basic and diluted	38,323,167	37,429,450
Net loss per common share, basic and diluted	$ (1.03)	$ (0.78)

Net Loss per Common Share - Pot

Net Loss per Common Share - Potentially Dilutive Securities Outstanding (Details) - shares	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities	6,901,937	4,705,122
Stock Options
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities	6,219,030	4,385,598
Restricted Stock Units
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities	667,366	303,983
Warrants
Antidilutive Securities Excluded From Computation Of Earnings Per Share [Line Items]
Antidilutive securities	15,541	15,541

Commitments and Contingencies -

Commitments and Contingencies - Schedule of Operating Lease Expense (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Loss Contingencies [Line Items]
Total operating lease expense	$ 290,769	$ 286,923
General and Administrative
Loss Contingencies [Line Items]
Total operating lease expense	$ 290,769	$ 286,923

Commitments and Contingencies_2

Commitments and Contingencies - Schedule of Future Minimum Lease Payments of Operating Leases (Details)	Mar. 31, 2022USD ($)
Lessee, Operating Lease, Liability, Payment, Due [Abstract]
2022	$ 885,000
2023	105,000
Total lease payments	990,000
Less imputed interest	(22,752)
Present value of operating lease liabilities	$ 967,248

Commitments and Contingencies_3

Commitments and Contingencies - Additional Information (Details)	1 Months Ended	3 Months Ended
	Jan. 31, 2022	Mar. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Lessee, operating lease, description		In January 2022, the Company entered into an agreement to extend the lease of 22 Cortlandt Street for a term of six months from August 1, 2022 through January 31, 2023.
Lease term	6 months
Operating lease, remaining lease term		9 months 18 days
Operating lease, discount rate		6.00%
Lessee, operating lease, existence of option to extend [true false]	true
Lessee, operating lease, option to extend		extend the lease of 22 Cortlandt Street for a term of six months from August 1, 2022 through January 31, 2023.

Stockholders' Equity - Addition

Stockholders' Equity - Additional Information (Details)	Dec. 05, 2019USD ($)	Dec. 31, 2019USD ($)	Mar. 31, 2022USD ($)Voted$ / sharesshares	Dec. 31, 2021$ / shares
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock, voting right per share | Vote			1
Weighted average grant date fair value | $ / shares			$ 21
Unrecognized compensation cost related to non-vested stock options expected to be recognized			$ 91,000,000
Expected vesting period for non-vested share-based compensation			3 years 3 months 18 days
Non-vested options outstanding | shares			6,169
Exercise price of warrants (in dollars per share) | $ / shares			$ 80.43	$ 80.43
Warrants | Term loan 2020 tranche one
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock to be issued if warrants are exercised (in shares) | shares			15,541
Exercise price of warrants (in dollars per share) | $ / shares			$ 80.43
Trading days | d			10
Term of warrants (in years)			7 years
Fair value			$ 900,000
Restricted Stock Units
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Vesting period			4 years
Compensation cost not yet recognized related to unvested RSUs			$ 19,500,000
Weighted average contractual term			3 years 7 months 6 days
2015 Plan
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Shares available for future grant | shares			2,187,058
2019 Shelf Registration
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Proceeds from issuance of common stock, gross	$ 261,200,000
SVB Leerink | December 2019 Sales Agreement
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock sales agreement, commission percentage		3.00%
SVB Leerink | March 2022 Sales Agreement
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock sales agreement, commission percentage			3.00%
SVB Leerink | December 2019 and March 2022 Sales Agreement
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Proceeds from issuance of common stock, gross			$ 32,000,000
Shares issued | shares			1,044,081
Proceeds from issuance of common stock, net			$ 31,000,000
Maximum | SVB Leerink | December 2019 Sales Agreement
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock sales agreement, authorized amount		$ 80,000,000
Maximum | SVB Leerink | March 2022 Sales Agreement
Share Based Compensation Arrangement By Share Based Payment Award [Line Items]
Common stock sales agreement, authorized amount			$ 200,000,000

Stockholders' Equity - Summary

Stockholders' Equity - Summary of Stock Option Activity (Details)	3 Months Ended
	Mar. 31, 2022USD ($)$ / sharesshares
Number of shares
Number of shares, Outstanding, beginning balance | shares	5,090,377
Number of shares, Granted | shares	1,223,019
Number of shares, Exercised | shares	(18,015)
Number of shares, Forfeited | shares	(67,139)
Number of shares, Expired | shares	(9,212)
Number of shares, Outstanding, ending balance | shares	6,219,030
Number of shares, Vested and expected to vest | shares	6,219,030
Number of shares, Exercisable | shares	2,932,835
Weighted average exercise price
Weighted average exercise price, Outstanding, beginning balance | $ / shares	$ 28.89
Weighted average exercise price, Granted | $ / shares	30.05
Weighted average exercise price, Exercised | $ / shares	10.08
Weighted average exercise price, Forfeited | $ / shares	43.83
Weighted average exercise price, Expired | $ / shares	53.10
Weighted average exercise price, Outstanding, ending balance | $ / shares	28.98
Weighted average exercise price, Vested and expected to vest | $ / shares	28.98
Weighted average exercise price, Exercisable | $ / shares	$ 15.85
Weighted average contractual term
Weighted average contractual term, Outstanding	7 years 7 months 6 days
Weighted average contractual term, Vested and expected to vest	7 years 7 months 6 days
Weighted average contractual term, Exercisable	5 years 8 months 12 days
Aggregate intrinsic value
Aggregate intrinsic value, Outstanding | $	$ 106,188,389
Aggregate intrinsic value, Vested and expected to vest | $	106,188,389
Aggregate intrinsic value, Exercisable | $	$ 82,434,018

Stockholders' Equity - Schedule

Stockholders' Equity - Schedule of RSU Activity (Details) - Restricted Stock Units	3 Months Ended
	Mar. 31, 2022$ / sharesshares
Number of shares
Number of shares, Outstanding, beginning balance | shares	302,764
Number of shares, Granted | shares	429,902
Number of shares, Vested | shares	(61,581)
Number of shares, Forfeited | shares	(3,719)
Number of shares, Outstanding, ending balance | shares	667,366
Weighted average grant date fair value
Weighted average grant date fair value, Outstanding, beginning balance | $ / shares	$ 42.93
Weighted average grant date fair value, Granted | $ / shares	23.27
Weighted average grant date fair value, Vested | $ / shares	41.49
Weighted average grant date fair value, Forfeited | $ / shares	48.73
Weighted average grant date fair value, Outstanding, ending balance | $ / shares	$ 30.36

Stockholders' Equity - Schedu_2

Stockholders' Equity - Schedule of Stock-Based Compensation Expense Recognized (Details) - USD ($)	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	$ 7,598,329	$ 3,731,097
Research and Development
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	1,809,477	1,534,395
General and Administrative
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Stock-based compensation expense	$ 5,788,852	$ 2,196,702

Stockholders' Equity - Schedu_3

Stockholders' Equity - Schedule of Warrant Activity (Details)	3 Months Ended
	Mar. 31, 2022$ / sharesshares
Warrants and Rights Note Disclosure [Abstract]
Number of warrants outstanding beginning balance | shares	15,541
Number of warrants issued | shares	0
Number of warrants exercised | shares	0
Number of warrants outstanding ending balance | shares	15,541
Weighted average exercise price, Beginning balance | $ / shares	$ 80.43
Issued (in dollars per share) | $ / shares	0
Exercised (in dollars per share) | $ / shares	0
Weighted average exercise price, Ending balance | $ / shares	$ 80.43

License Agreements - Additional

License Agreements - Additional Information (Details)	1 Months Ended	3 Months Ended		12 Months Ended
	Jan. 31, 2020USD ($)$ / sharesshares	Mar. 31, 2022USD ($)shares	Mar. 31, 2021USD ($)	Dec. 31, 2020USD ($)	Dec. 31, 2012Item	Dec. 31, 2021USD ($)shares	Jan. 09, 2020USD ($)$ / shares
Research And Development Arrangement Contract To Perform For Others [Line Items]
Number of common shares | shares		38,883,445				37,816,794
Value of common stock		$ 3,888				$ 3,782
Research and development expense recognized		12,585,141	$ 16,595,689
License Agreement | Antecip
Research And Development Arrangement Contract To Perform For Others [Line Items]
Number of exclusive license agreements | Item					3
License agreement royalty, maximum reduction percent as a result of required third party payments					50.00%
License agreement term, from first commercial sale					10 years
License Agreement | Antecip | AXS-02
Research And Development Arrangement Contract To Perform For Others [Line Items]
License agreement royalty as a percent of net sales					4.50%
License Agreement | Antecip | AXS-05
Research And Development Arrangement Contract To Perform For Others [Line Items]
License agreement royalty as a percent of net sales					3.00%
License Agreement | Antecip | AXS-04
Research And Development Arrangement Contract To Perform For Others [Line Items]
License agreement royalty as a percent of net sales					1.50%
Pfizer Inc | License Agreement
Research And Development Arrangement Contract To Perform For Others [Line Items]
Number of common shares | shares	82,019
Value of common stock	$ 8,000,000
Prior trading days	10 days
Share price | $ / shares	$ 97.54
Upfront cash payment	$ 3,000,000
Fair value share price | $ / shares							$ 87.24
Fair value of common stock							$ 7,200,000
Research and development expense recognized				$ 10,200,000
Future milestone payments		323,000,000
Milestone payments or royalties		$ 0	$ 0