Investor Presentation 21 November 2019

1 Forward-Looking Statement Safe-Harbor

This presentation contains forward-looking statements about Minerva whether any of our therapeutic products will advance further in the Neurosciences which are subject to the safe harbor provisions of the clinical trials process and whether and when, if at all, they will receive Private Securities Litigation Reform Act of 1995, as amended. Forward- final approval from the U.S. Food and Drug Administration or looking statements are statements that are not historical facts, reflect equivalent foreign regulatory agencies and for which indications; management’s expectations as of the date of this presentation, and whether the results of future clinical trials of roluperidone, seltorexant, involve certain risks and uncertainties. Forward-looking statements MIN-117 and MIN-301, if any, will be consistent with the results of past include, but are not limited to: the benefits, efficacy and safety of our clinical trials; whether roluperidone, seltorexant, MIN-117 and MIN-301 new formulations; the potential of the diagnosis and treatment of will be successfully marketed if approved; whether our therapeutic negative symptoms of schizophrenia and other diseases; whether product discovery and development efforts will be successful; our studies performed on analogs or backups of our compounds are a good ability to achieve the results contemplated by our co-development predictor of the clinical efficacy of our compounds; statements with agreements; the strength and enforceability of our intellectual property respect to the timing and results of future clinical milestones with rights; competition from pharmaceutical and biotechnology companies; roluperidone (MIN-101), seltorexant (MIN-202) and MIN-117, including the development of and our ability to take advantage of the market for the Phase 3 trial of roluperidone, the Phase 2b trials of seltorexant and our therapeutic products; our ability to raise additional capital to fund the Phase 2b trial of MIN-117; statements regarding our ability to our operations on terms acceptable to us; and general economic successfully develop and commercialize our therapeutic products; our conditions. These and other potential risks and uncertainties that could expectations regarding approval for our products by the U.S. Food and cause actual results to differ from the results predicted are more fully Drug Administration or equivalent foreign regulatory agencies; detailed under the caption “Risk Factors” in our filings with the estimates regarding the market potential for our products; and future Securities and Exchange Commission, including our Quarterly Report on performance. All of such statements are subject to certain risks and Form 10-Q for the quarter ended September 30, 2019, filed with the uncertainties, many of which are difficult to predict and generally Securities and Exchange Commission on November 4, 2019. Copies of beyond the control of the Company, that could cause actual results to reports filed with the SEC are posted on our website at differ materially from those expressed in, or implied or projected by, www.minervaneurosciences.com. Our audience is cautioned not to the forward-looking statements. These forward-looking statements are place undue reliance on these forward-looking statements that speak based on our current expectations and may differ materially from only as of the date hereof, and we disclaim any obligation to update actual results due to a variety of factors including, without limitation, any forward-looking statements, except as required by law.

All trademarks, trade names and service marks appearing in this presentation are the property of their respective owners. 2 Minerva Neurosciences (NASDAQ: NERV)

• Founded in 2014

• Our goal is to transform the lives of patients suffering from CNS disease including schizophrenia, depression, insomnia and Parkinson’s disease

• Our late stage clinical programs focus on the development of several proprietary compounds which have innovative mechanisms of actions which in turn we believe will lead to better treatments for patients

3 Advancing a broad pipeline to address unmet needs in CNS healthcare

Primary Mechanism of Program Preclinical Phase 1 Phase 2 Phase 3 Indications Action

• Negative 5-HT2A antagonist Roluperidone • Sigma antagonist symptoms in 2 Pivotal Phase 3 (MIN-101C07) Top Line Readout H1 ’20 MIN-101 • α -adrenergic antagonist schizophrenia 1A • α1B-adrenergic antagonist

• 5-HT1A antagonist Major depressive • 5HT transporter disorder and • α -adrenergic antagonist Phase 2b (MIN-117C03) Top Line Readout Q4’19 MIN-117 1A anxiety, as • α1B-adrenergic antagonist monotherapy • Dopamine transporter • 5-HT2A antagonist

Phase 2b (MDD2001) Top Line Readout Q2 ’19 Primary insomnia completed Seltorexant • Selective orexin-2 Major depressive Phase 2b (ISM2005) Top Line Readout Q2 ’19 MIN-202 antagonist (SORA) completed disorder, as adjunctive therapy Phase 2 (MDD2002) Top Line Readout Q3 ‘19 completed

Parkinson’s • Neuregulin-1β1 activating Pre-clinical MIN-301 disease ErbB4

4 MIN-117

An opportunity to address the unmet needs of the MDD patient population

5 Our goal is to develop medicines that treat the unmet needs in depression

MIN-117 is the only anti-depressant to Treatment- effectively inhibit resistant* Serotonin and Dopamine reuptake

Targets 5-HT receptor directly, while also Faster onset of 1A targeting 5-HTT (or SERT) & DAT, believed to action* result in a fast onset of action

Improved MIN-117 has been generally tolerability* well tolerated in studies to date

Targets 5-HT receptor directly, believed to Treat anxiety 1A result in a reduction of anxiety

*Datamonitor Healthcare proprietary depression survey 6 MIN-117 C01: Phase 2a

A randomized, double-blind, parallel-group, placebo- and active-controlled study to evaluate the efficacy and safety of 2 doses of MIN-117 in adult subjects with major depressive disorder

7 MIN-117 C01: Phase 2a randomized placebo controlled efficacy & safety study

4 week screening phase 6 week double-blind treatment 2 week post-treatment including washout phase (outpatient) follow-up visit (day -28 to day -1) (day 1 to day 42) (day 43 to day 56)

Randomization Primary Endpoint

Placebo PO,QD MIN-117 0.5mg PO,QD Off study drug; MIN-117 2.5mg PO,QD follow up Paroxetine 20mg PO,QD

Primary endpoint: Changes from baseline in MADRS total score Secondary endpoints: CGI-S response, CGI-I response, Hamilton Anxiety (HAM-A), Arizona Sexual Experiences Scale, Digit-Symbol Substitution Test, Digit Span Backwards task Number of patients: 80 patients randomized 1:1:1:1

8 MIN-117 C01: Efficacy – MADRS (ITT population)

Effect sizes MIN-117 0.5 mg: 0.24 MIN-117 2.5 mg: 0.34

Week 1 Week 2 Week 4 Week 6

Source: Clinical Study Report, data on file. 9 MIN-117 C01: HAM-A efficacy (ITT population)

Effect sizes MIN-117 0.5 mg: 0.49 MIN-117 2.5 mg: 0.45

Week 1 Week 2 Week 4 Week 6

Source: Clinical Study Report, data on file. 10 MIN-117 C01 (Phase 2a) : Findings

■ 24% of the patients treated with MIN-117 2.5 mg dose achieved full remission as prospectively defined (no patients in the study treated with paroxetine achieved remission)

■ Compared to placebo, the number of patients who achieved remission based on a MADRS score of < 12, on the 2.5 mg dose had an odds ratio (OR) of 2.1 by week 4 (0.5 for paroxetine), and 3.1 by week 6 (1.1 for paroxetine)

■ The 2.5 mg dose was superior to paroxetine when evaluating the rate of response based on the definition of reduction from baseline MADRS score by ≥ 50%

■ MIN-117 preserved sleep continuity and architecture and therefore is not expected to have detrimental effects on REM distribution and duration (as observed with SSRIs and SNRIs)

■ Both doses of MIN-117 demonstrated a favorable tolerability profile, and the incidence and types of side effects were comparable to placebo

■ Treatment with MIN-117 was not associated with cognitive impairment, sexual dysfunction, suicidal ideation or weight gain

11 MIN-117C03: Phase 2b

Fully recruited Top Line Results Q4 2019

A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study to Evaluate the Efficacy and Safety of 2 Fixed Doses (5.0 mg or 2.5 mg) of MIN-117 in Adult Subjects with Major Depressive Disorder

12 MIN-117 C03: Phase 2b study to evaluate efficacy and safety in 360 patients with moderate to severe MDD with anxiety.

3 week screening phase 6 week double-blind treatment 2 week post-treatment including washout phase (outpatient) follow-up visit (day -21 to day -1) (day 1 to day 42) (day 43 to day 56)

Randomization Primary Endpoint

Placebo PO,QD Off study drug; MIN-117 2.5mg PO,QD follow up MIN-117 5.0mg PO,QD

Primary endpoint: Reduction from baseline in MADRS total score after 6 weeks of treatment Secondary endpoints: CGI-S response, CGI-I response, Hamilton Anxiety (HAM-A), Number of patients: 360 patients randomized 2:1:1

13 Minerva’s development pipeline

Primary Mechanism of Program Preclinical Phase 1 Phase 2 Phase 3 Indications Action

• Negative 5-HT2A antagonist Roluperidone • Sigma antagonist symptoms in 2 Pivotal Phase 3 (MIN-101C07) Top Line Readout H1 ’20 MIN-101 • α -adrenergic antagonist schizophrenia 1A • α1B-adrenergic antagonist

• 5-HT1A antagonist Major depressive • 5HT transporter disorder and • α -adrenergic antagonist Phase 2b (MIN-117C03) Top Line Readout Q4’19 MIN-117 1A anxiety, as • α1B-adrenergic antagonist monotherapy • Dopamine transporter • 5-HT2A antagonist

Phase 2b (MDD2001) Top Line Readout Q2 ’19 Primary insomnia completed Seltorexant • Selective orexin-2 Major depressive Phase 2b (ISM2005) Top Line Readout Q2 ’19 MIN-202 antagonist (SORA) completed disorder, as adjunctive therapy Phase 2 (MDD2002) Top Line Readout Q3 ‘19 completed

Parkinson’s • Neuregulin-1β1 activating Pre-clinical MIN-301 disease ErbB4

14 Seltorexant (MIN-202)

A first-in-class selective Orexin-2 antagonist for MDD and insomnia

MDD2001 positive TLR MDD2002 positive TLR ISM2005 positive TLR MDD1009 positive TLR Phase III programs in planning

A co-development/co-commercialization program with

15 Seltorexant (MIN-202) Phase 2b MDD2001 trial design and key results

■ First MDD trial initiated Sep 2017 (clinicaltrials.gov: NCT03227224) ● Double-blind, randomized, parallel-group, placebo-controlled adaptive dose-finding study ● 4-week screening, 6-week double-blind treatment, and 2-week follow-up ● 287 patients enrolled at 84 clinical sites in the US, Europe, Russia, and Japan - Safety and tolerability and dose-response and efficacy for up to 3 doses of seltorexant (10mg, 20mg & 40mg)

. Seltorexant 20mg showed a statistically significant improvement in the MADRS score compared to placebo

. Seltorexant was well tolerated with an adverse events rate similar to that of

placebo

SE) of change in MADRS Total Score SE)of MADRSin change Total

- LS Mean Mean LS (+/

Source: Clinical Study Report, data on file. 16 Seltorexant (MIN-202) Phase 2b MDD2002 trial design and key results

■ Second MDD trial initiated Dec 2017 (clinicaltrials.gov: NCT03321526) ● Double-blind, randomized, randomized, flexible-dose parallel-group study ● 4-week screening, 6-month double-blind treatment, and 2-week follow-up ● 102 patients enrolled at clinical sites in the US, Europe, Russia, and Japan —Assess the efficacy of flexibly dosed seltorexant compared with flexibly dosed quetiapine as adjunctive therapy to baseline antidepressant therapy (either an SSRI or SNRI) in delaying time to all-cause discontinuation of study drug over a 6-month treatment period

MADRS Total Score change over time by modal dose

• Primary endpoint all-cause discontinuation over 6 months, seltorexant (41%) over quetiapine (47%); not powered to detect statistical significance.

• 20 mg dose of seltorexant demonstrated a larger improvement at week 24 in the MADRS (-22.7 points) than patients in other groups.

• As seen in the previous MDD trial, subjects with sleep disturbance (Insomnia Severity Index ≥15) who received the 20 mg dose of seltorexant showed greatest improvement.

Source: Clinical Study Report, data on file. 17 Seltorexant (MIN-202) Phase 2b ISM2005 trial design and key results

■ Insomnia trial initiated Dec 2017 (clinicaltrials.gov: NCT03375203) ● Double-blind, randomized, parallel-group, active- and placebo-controlled adaptive dose-finding study ● Up to 61-day duration, including screening and follow-up ● 365 patients enrolled at 56 clinical sites in the US, Europe and Japan (~70 in each group) ● Efficacy and safety analyzed in both adults and elderly subjects randomized to receive placebo, seltorexant (5 mg, 10 mg and 20 mg), and zolpidem (available under Ambien brand name)

• Primary Endpoint LPS at night 1, with adjusted 1-sided p-values <0.001.

• Mean decreases from baseline at Night 1 in LPS were 15 minutes for placebo, 30 minutes for seltorexant 5 mg, 43 minutes for seltorexant 10 mg, and 45 minutes for seltorexant 20 mg.

• Seltorexant showed superior and more sustained efficacy compared to zolpidem.

• Seltorexant showed a good safety and tolerability profile in both adult and elderly patients.

Source: Clinical Study Report, data on file. 18 Roluperidone (MIN-101)

Phase 3

Enrollment to be completed at approximately year-end 2019 Top Line Results H1 2020

19 Roluperidone (MIN-101 C07): Pivotal phase 3 study to evaluate efficacy and safety in 501 schizophrenic patients with negative symptoms

4 week screening phase 12 week double-blind 40 week open label including washout treatment phase extension phase (day -28 to day -1) (day 1 to day 84) (day 85 to day 364)

Randomization Primary Endpoint MIN-101 32mg Placebo PO,QD Crossover MIN-101 64mg MIN-101 32mg PO,QD MIN-101 64mg PO,QD

Primary endpoint: Reduction in PANSS Negative Symptoms Factor Score (NSFS) from baseline (Marder) after 12 weeks administration Secondary endpoints: Personal and Social Performance scale (PSP), Clinical Global Impression of Severity (CGI-S), 40 weeks (9 months) open-label extension Number of patients: 501 patients randomized 1:1:1 (167 in each arm) Main inclusion criteria: DSM-5 schizophrenia diagnosis, Baseline score ≥ 20 on the 7 PANSS “N” items, Symptomatically stable and manifesting negative symptoms for 6 months as judged by the PI, Age 18-55

20 Roluperidone : A reminder of the Phase 2b data - continuous improvement in negative symptoms over 36 weeks

Change from Baseline in PANSS Negative Symptoms Factor Score (Pentagonal Structure Model) (ITT Population) WEEK 0 6 12 18 24 30 36 1

0

-1 Negative from Baseline -2 -3

symptoms SEM Change

± -4

Mean -5

-6

-7 Placebo MIN-101 32 mg MIN-101 64 mg "0" Line

Change from Baseline in PANSS Positive Symptoms Factor Score (Pentagonal Structure Model) (ITT Population) WEEK 0 6 12 18 24 30 36 2.0

1.5

1.0

0.5 from Baseline Positive 0.0 symptoms -0.5

SEM Change -1.0 ±

-1.5 Mean -2.0 21 -2.5

-3.0 Placebo MIN-101 32 mg MIN-101 64 mg "0" Line

Source: Clinical Study Report, data on file. 21 Our challenge: around 60% of patients diagnosed with schizophrenia and treated have negative symptoms and are relapse free for at least 6 months

Estimated prevalence of SZ (0.88%) Schizophrenia.com: 2.2 million US adults 2.2 million patients in US

Prevalence of US adults Treatment prevalence with schizophrenia in of SZ (0.53%) Phase 3 enrolled treatment/yr: 0.53%1 1.3 million US adults population is representative of Negative symptoms 780,000 patients in (69%) the US 0.9 million US adults

69% of patients have negative symptoms: Stable patients (85%): ≈42%2,3 predominant/ 2,3 15% weighted-average 0.78 million US adults prominent symptoms; 6-month relapse rate among ≈27%4 mild symptoms patients with varying severity of negative symptoms

SZ=schizophrenia. 1.Wu et al. Psychol Medicine. 2006; 2. Millier et al. J Market Acc Health Policy. 2017; 3.Haro et al. Schizophr Research. 2015; 4. Nordstroemet al. J Social Psychiatry. 2017. 22 The changing landscape for patients with schizophrenia

2027 Forecast 2017

5HT2a/Sigma2 Roluperidone

99% 64%

Atypical - oral Atypical - LAI Other

Mixed Neurotransmitter Modulators Selective Serotonin Modulators Other Roluperidone

Based on Schizophrenia Disease Landscape & Forecast. Decision Resources Group. Nov 2018 23 Summary

Lead product in Phase 3 ► Roluperidone study enrollment expected to be complete ~year end 2019; TLR expected first half 2020

Phase 2b study ongoing ► MIN-117 MDD enrollment completed, TLR Q4 2019

Three Phase 2b TLR readouts ► Seltorexant MDD (two trials) in 2019 support Phase 3 design ► Seltorexant insomnia

Well capitalized through ► $60m cash balance on September 30, 2019 multiple data read-outs in 2019/H1 2020 ► Cash runway to mid-2021

24