Sales of Johnson & Johnson’s esketamine-based nasal spray jumped in the fourth quarter last year, priming the pump for a suite of other pharmas, including AbbVie, champing at the bit with their own psychedelics.
While AbbVie executives avoided going into many specifics regarding the pharma’s new psychedelic drug, acquired for $1.2 billion from Gilgamesh Pharmaceuticals last August, the company did refer to DMT-related bretisilocin, being developed for major depressive disorder, as a “breakthrough type therapy.”
There are a couple of elements behind this definition, AbbVie Chief Scientific Officer Roopal Thakkar said during the company’s fourth quarter earnings call on Wednesday; it allows patients to have a short hallucinatory period which dissipates rapidly, allowing them to leave the clinic quickly.
Bretisilocin is already backed by Phase 2 data. In March 2025, Gilgamesh unveiled results showing that nearly all 40 patients with major depressive disorder (MDD) treated with the drug went into disease remission. AbbVie, now the drug’s steward, is this year expecting additional Phase 2 data from two cohorts that could guide its Phase 3 plans, according to Thakkar’s comments on the call.
Meanwhile, Johnson & Johnson’s hallucinogen spray Spravato keeps on growing, making good on years of anticipation that psychedelics could capture a similar market and treat a high unmet patient need in hard-to-treat mental health conditions. That could be music to AbbVie’s ears.
J&J reported that sales of Spravato hit $503 million in the fourth quarter of last year, a 69% bump over the same period in 2024, and $1.7 billion for the full year.
“We are very encouraged by the progress of Spravato,” CEO Joaquin Duato said on the company’s earnings call on Jan. 21. After the call, analysts concurred with Duato that patients with historically difficult conditions like MDD stand to benefit.
“Spravato’s commercial momentum . . . provides evidence that psychedelics can generate meaningful sales in hard-to-treat CNS disorders,” Jefferies analysts wrote in a Jan. 21 note after J&J’s earnings call, “even if their ultimate use were restricted to hospitals or treatment clinics (vs at home) - incrementally increasing the perception psychedelics are an investable space.”
J&J’s success with the ketamine-derivative Spravato will pave the way for other companies too, according to Jefferies, as the company’s efforts to build out the infrastructure at hospitals and with physicians and securing reimbursement with payers “should only help facilitate the adoption of future psychedelics.”
Meanwhile, smaller biotechs like Compass Pathways and Definium are waiting in the wings with their own psychedelics. Compass has multiple Phase 3 readouts planned this year for its psilocybin-based therapy for treat-resistant depression, COMP360, while Definium—formerly MindMed—will drop three Phase 3 datasets for its LSD-based drug DT120 for generalized anxiety disorder and MDD. Both companies are likely to apply for FDA approval before the end of this year, Wainwright analyst Patrick Trucchio told BioSpace last month.
“So by 2027, that’s a reality that DT120 and COMP360 are probably going to be approved,” he predicted.
