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ATAI Investor Presentation Deck

R-ketamine vs. S-ketamine in preclinical models: Higher-potency, longer lasting antidepressant effect and lower potential for abuse Profile of R- vs. S-ketamine. HN Ketamine (racemate) S-ketamine HN HN R-ketamine R-ketamine lacks the psychotomimetic and abuse potential of S-ketamine at therapeutic doses in preclinical models. Like S-ketamine, R-ketamine's mechanism involves increased neuroplasticity through glutamatergic modulation, with potency differences putatively arising from: Different active metabolite profiles • Different pre- and post-synaptic sites of action • Involvement of different intracellular pathways (mTORC1 vs. ERK) More durable & effective Forced swim test¹ (third party study) Immobility time (s) 240 Escape failures 180 120 60 40 30 SAL 10 Learned helplessness test SAL 1 3 10 30 1 hour (S)-KET (mg kg-¹) (1) Zanos et al., "NDMAR inhibition-independent antidepressant actions of ketamine metabolites" (2016); (2) Yang et al., "R-ketamine: a rapid-onset and sustained antidepressant without psychotomimetic side effects" (2015). T 15 (S)-KET (mg kg-¹) 1 3 10 30 25 (R)-KET (mg kg-¹) 1 5 25 (R)-KET (mg kg-¹) SAL 24 hours 1 3 10 30 (S)-KET (mg kg-¹) 1 3 10 30 (R)-KET (mg kg-¹) R-ketamine outperformed and outlasted S-ketamine in mice; confirmed in multiple other animal models in different labs Lower potential for abuse Conditioned place preference score test² (third party study) CPP Scores CPP Scores 500 400 300 200 100 0 -100 500 400 300 200 100 0 -100 Saline. (RS)-Ketamine (10mg/kg) R-Ketamine < abuse potential Saline 5mg/kg 10mg/kg 20mg/kg (R)-Ketamine CPP Scores 500 400 300 200 100 0 -100 Saline 5mg/kg 10mg/kg 20mg/kg (S)-Ketamine R-ketamine showed less potential for abuse in mice models, while racemic and S-ketamine have significant risk Note: mTORC1 = Mechanistic target of rapamycin complex 1, ERK= Extracellular signal-regulated kinases. Sources: Wei et al., "A historical review of antidepressant effects of ketamine and its enantiomers" (2020); Chang et al., "Comparison of antidepressant and side effects in mice after intranasal administration of (R,S)-ketamine, (R)-ketamine, and (S)-ketamine Pharmacology Biochemistry and Behavior" (2019); 15
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