Meet Herriot Tabuteau, the Haiti-Born Black Billionaire Behind Axsome Therapeutics

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Published by Stephen Oluwadara at February 18, 2026

Dr Herriot Tabuteau and Axsome Therapeutics’ Humble Beginnings

Tabuteau was born in Haiti in 1968, where his birth mother struggled to raise him and his sister. He recalls experiencing neglect of all kinds, “physical, nutritional, emotional, but it taught me resilience,” he told Forbes.

At age 9, he relocated with his dad and adoptive mom to Manhattan’s Upper East Side. Studying molecular biology and biochemistry at Wesleyan led him to Yale’s School of Medicine, where he planned to become a neurosurgeon.

As his interests shifted toward the business of drug discovery, his professors grew uneasy, and it really got under his skin. He made a drastic switch, trading in his neurosurgery residency for a job at Goldman Sachs’ healthcare investment-banking group. That was the start of a nearly two-decade career in finance. He went on to work at Bank of America Securities, hedge fund Healthco/S.A.C. Capital, and even managed his own funds.

From his office on Wall Street, he watched thousands of early-stage biotechs succeed and fail, and began to develop his own theories about what worked and why. While most biotechs focus on just one drug, he realized building a portfolio would cut the risk of a flop.

In 2012, Tabuteau finally launched his biotech startup: Axsome Therapeutics. Axsome came from the axon and soma of a nerve cell. The company has evolved significantly since its humble beginnings in a small, windowless office at Rockefeller Center in New York.

Axsome’s early years were marked by struggle. To keep costs low, the Haitian-American shunned the industry’s practice of outsourcing clinical trials, betting he could do it cheaper and with a greater chance of success in-house. A Phase III trial would have cost $50 million; Tabuteau could do it for 30% to 50% less.

“We got a lot of pushback,” he says, as investors didn’t believe he could run so many trials on such a low budget. Working on multiple drugs helped: When one trial ended, his researchers would immediately begin work on the next candidate

From Promising Startup to Multibillion-Dollar Empire

The biotech company went public in 2015, but its stock price languished under $10 for years, dipping below a $100 million market cap after a failed pain drug trial. “Nobody believed in Axsome years ago, and I think there’s still a lot of unbelievers,” Axsome chief financial officer Nick Pizzie said. “It’s a show-me story.”

The company’s fortunes changed with Auvelity, a treatment for major depressive disorder that gained FDA approval in August 2022. This sent shares soaring 65% in a week, valuing Axsome at $3 billion. Auvelity combines two existing medications, working faster than traditional antidepressants. Axsome launched the drug with a targeted approach, using software to identify receptive doctors and tailor their sales strategy.

Auvelity is on track for $500 million in sales this year, with analysts predicting blockbuster status. In early 2025, the company resolved patent litigation that will keep copycats off the market until at least 2038, a big win.

Tabuteau’s finance expertise has been invaluable for the startup. In 2022, Axsome acquired a drug called Sunosi, which treats excessive daytime sleepiness in people with narcolepsy or sleep apnea. The company secured a deal to buy the drug for $53 million (plus single-digit royalties) in just two weeks over Christmas in 2021.

Less than a year later, he sold the European, Middle Eastern, and North African rights to the drug for $66 million (plus milestones and royalties). This sale allowed Axsome to more than recoup its initial investment. Sunosi’s revenue is now over $100 million annually.

Shares have kept rising, shooting up 35% over the past year to a recent $122, outperforming the Nasdaq Biotech Index, which is up just 1% over the same period. The next treatment to watch is a drug to treat the agitation that often accompanies Alzheimer’s disease.

However, antipsychotic medications, currently the only treatment available, have serious risks, including death. Axsome’s drug avoids these side effects but has reported mixed results in Phase III clinical trials. Axsome filed for approval before the end of September. However, the FDA has accepted the supplemental New Drug Application (sNDA) for AXS-05 and granted it Priority Review, with a target action date of April 30, 2026. This means an approval decision is expected by that date.

Even if the FDA does not greenlight it, analysts expect the need for an alternative to antipsychotics to make approval likely. It’s core to Tabuteau’s plans to get the value of Axsome to $16.5 billion: He projects $1 billion to $3 billion in sales for Auvelity and $1.5 billion to $3 billion from the Alzheimer’s agitation drug annually at their peak.

“There is so much ahead of us right now in terms of the pipeline and the number of patients we’re able to address,” he says. “We might be a small company in terms of size, but we’re not a small company in terms of fundamentals or in terms of ambition.”

Axsome Therapeutics’ Scale of Impact and Way Forward

Axsome Therapeutics went public in 2015 at $9 per share, valuing the company at $180 million. Fast forward to early 2025, and the stock traded at around $103, giving Axsome a whopping $5 billion valuation.

Dr. Tabuteau’s got 7.35 million shares, about 15% of the total outstanding shares, which puts his current net worth at roughly $760 million. Remarkably, on Feb 21, 2025, the stock hit $137, and his shares were worth over $1 billion, consolidating his position as a billionaire. As of today, the stock is worth 180.84 per share.

Axsome has the potential to help the estimated 150 million Americans suffering from conditions like depression, ADHD, or Alzheimer’s disease. Revenue for the 12 months ended in June 2025 reached $495 million, up 70% from the same period in 2024. Axsome is not yet profitable, booking a net loss of $247 million in that time.

Dr. Herriot Tabuteau’s journey from immigrant student to billionaire CEO is a powerful example of how one person’s determination and innovative spirit can drive change. He identified a need for solutions where patients were suffering and leveraged his unique blend of medical expertise and financial acumen to address it.

Main Image: Herriot Tabuteau graphic, created by UrbanGeekz