Ep205: Heather Turner on a Schizophrenia Drug Patients Can Stick With
Heather Turner, CEO of LB Pharmaceuticals, discusses her unconventional path from corporate attorney to biotech CEO, leading the development of LB102, a methylated derivative of amisulpride for treating schizophrenia and other neuropsychiatric disorders. She successfully navigated a challenging IPO during a biotech financing freeze and is now advancing the compound through late-stage clinical trials with a focus on improving patient adherence and reducing side effects.
Summary
Heather Turner grew up in Los Angeles as a competitive soccer player and public school student with parents in business and engineering. She initially pursued environmental law at UCLA but shifted focus toward startup companies after realizing the frustration of environmental law's political dependencies. She joined Cooley LLP in the late 1990s as a corporate attorney, where she specialized in taking life science companies public and developed a deep appreciation for the biotech industry's ability to create multiple stakeholder benefits by focusing on patients.
Turner transitioned to in-house roles starting with her first general counsel position at Orexigen Therapeutics, an obesity drug company. Over her career at multiple companies (Orexigen, Atara, Lyell, Sangamo), she consistently took on new responsibilities beyond legal work, including government affairs, portfolio strategy, HR, investor relations, and corporate development. She eventually moved into a COO role at Karmot Therapeutics, a GLP-1 receptor agonist company for weight loss. When the founding CEO departed, she was promoted to CEO, leading the company through a successful dual IPO and acquisition process that resulted in Roche acquiring Karmot for $2.7 billion upfront plus $400 million in milestones in 2024.
After six months at Roche and five months off, Turner joined LB Pharmaceuticals in November 2024 as CEO. The company is developing LB102, a methylated derivative of amisulpride (an antipsychotic approved in over 50 countries but never in the US). The modification improves blood-brain barrier penetration, enabling once-daily dosing instead of twice-daily and lower doses. Phase two data showed strong efficacy compared to placebo, a favorable safety profile with notably low rates of extrapyramidal symptoms (movement disorders), and robust effects on cognitive function.
Facing a severe biotech financing freeze in early 2025, Turner made the unconventional decision to conduct an IPO despite having only $14 million cash, no crossover investors, and a two-year timeline to first catalyst—all typically unfavorable IPO conditions. She used a 'testing the water' approach, allowing investors to dictate pricing rather than the company. This self-selected for long-term investors who understood the investment thesis. She also ensured employees remained whole through stock option repricing and new grants. Subsequently, a new investor executed a $100 million PIPE in February, enabling addition of adjunctive major depressive disorder to the pipeline. The company now has runway into Q2 2029.
About this episode
Heather Turner, CEO of New York-based LB Pharma, on developing a new schizophrenia drug designed to better cross the blood-brain barrier, be dosed once daily, and make it easier for patients to take long term.
Key Insights
- Turner argues that general counsel roles uniquely position attorneys to understand entire organizations by reviewing risk across all functions, seeing natural tensions between departments, and attending board meetings, which provides exceptional training for CEO-level business decision-making.
- Turner claims that biotech is one of the few industries where focusing on patient benefit creates win-win outcomes for patients, physicians, employees, companies, and stockholders simultaneously.
- Turner discovered through experience that taking on new responsibilities and learning new areas of business (government affairs, portfolio strategy, HR, investor relations, corporate development) was not only possible but expected in biotech, creating continuous opportunities for growth.
- Turner asserts that managing placebo response rates in neuropsychiatric trials is critically important and underestimated, since these conditions rely on subjective symptom scales rather than objective measurements, making high placebo responses a major trial risk.
- Turner states that LB102's methylation modification improves lipophilicity, enabling more efficient blood-brain barrier penetration, which allows for lower doses, once-daily dosing, and potentially a longer residence time in the brain compared to amisulpride.
- Turner reports that Phase two data for LB102 showed statistically significant efficacy across all tested doses (50, 75, 100mg) compared to placebo, low rates of extrapyramidal symptoms, favorable discontinuation rates, and robust cognitive improvements.
- Turner argues that during the severe 2025 biotech financing freeze, she deliberately adopted an investor-dictated pricing model in the IPO rather than company-dictated pricing to signal confidence and attract long-term investors despite having only $14 million cash and a two-year timeline to catalyst.
- Turner identifies care partners and family units as critically important but underestimated components of mental illness treatment, noting that these diseases impact entire families and require care partner involvement in treatment plans.
- Turner claims that cognitive impairment is a persistent problem across multiple psychiatric indications—affecting 80% of schizophrenia patients, 45-60% of bipolar disorder patients, and similar percentages of MDD patients—and represents a therapeutic opportunity.
- Turner asserts that amisulpride is considered one of the more efficacious and safe/tolerable antipsychotics globally despite never being approved in the US, representing an underutilized therapeutic option that LB102 aims to improve upon.
- Turner states that her husband planting the seed that she would become a CEO approximately one year before she was actually promoted to CEO was instrumental in mentally preparing her to accept the role when it arose.
- Turner argues that the two-year timeline to first clinical catalyst served as an effective investor filter during the IPO, self-selecting for investors who appreciated early-stage positioning rather than those seeking near-term catalysts.
Topics
Transcript
Welcome to The Long Run. This is a podcast for biotech adventurers. I'm your host, Luke Timmerman. Today's guest is Heather Turner. Heather is the CEO of New York-based LB Pharmaceuticals. It's a company developing treatments for serious mental health disorders such as schizophrenia, depression, and bipolar disorder. The company is running late-stage clinical trials for its lead drug candidate, LB102. And this is a methylated derivative of Amisulpride, which is a benzamide antipsychotic that's approved in more than 50 countries but never made it to the market in the US before going generic. The LB modification is supposed to make the compound more efficiently cross the blood-brain barrier so it can be given in lower doses and once a…
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