Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Informational only. Not medical advice.INFORMATIONAL PLATFORM ONLY — NOT MEDICAL ADVICE, DIAGNOSIS, OR TREATMENT
Head-to-head comparison of ISRIB and NSI-189 — mechanism, side effects, legal status, and pricing.
ISRIB is a non-peptide small-molecule eIF2B activator (bis-chlorophenoxyacetamide-cyclohexane class) that antagonizes the integrated stress response (ISR) by stabilizing the eIF2B guanine-nucleotide exchange factor complex. It is not an approved drug and has no completed human clinical trials or validated human safety or efficacy data. Chemically distinct eIF2B-activator analogs (DNL343, ABBV-CLS-7262) have reached human trials, but DNL343 missed primary endpoints in a Phase 2/3 ALS trial (January 2025). ISRIB is sold by reagent suppliers for research use only.
NSI-189 (INN: amdiglurax; developmental code ALTO-100) is a non-peptide small-molecule benzylpiperazine-aminopyridine derivative investigated as a neurogenic/neuroplasticity-modulating agent for major depressive disorder. It stimulates hippocampal neural progenitor proliferation and differentiation in vitro and neurogenesis in vivo (mouse), acting independently of monoamine reuptake pathways. NSI-189 has never been FDA-approved; Phase 2 monotherapy trials in MDD (220 patients, 2020) and a Phase 2b trial under Alto Neuroscience (~300 patients, 2024) both failed to meet primary MADRS endpoints, and it remains investigational only.
ISRIB
NSI-189
Category
Legal Status
Mechanism
Side Effects
COA-verified vendors · trust score ≥70 required · single-vial price — bulk/bundle deals may be lower
ISRIB
NSI-189
No pricing data yet.
Check NSI-189 prices →COA corpus from Disclosed Labs — independently tested batches only.
ISRIB
1
COAs
99.8%
Avg purity
1
Labs
NSI-189
No COA data yet.
Submit testing data →No completed or published human clinical trials of ISRIB itself exist; it has no validated human pharmacokinetic, safety, or efficacy data. In mice, systemic ISRIB enhanced spatial and fear-associated long-term memory in healthy animals, reversed hippocampus-dependent spatial-learning and working-memory deficits weeks after traumatic brain injury, and reset elevated ISR activity in aged (18–24 month) mice, reversing age-related spatial-memory decline with a brief 3-day dosing course. In prion-disease transgenic mice, ISRIB partially restored protein synthesis and prevented neurodegeneration without the pancreatic exocrine toxicity seen with PERK-inhibitor approaches. In vitro and in a patient-derived xenograft mouse model, ISRIB combined with imatinib attenuated RAS/RAF/MAPK and STAT5 signaling and eliminated therapy-resistant chronic myeloid leukemia cells.
Key references
Human data exist from three registered trials: a Phase 1 single-dose PK study in healthy volunteers (NCT01310881), a Phase 1B multiple-dose-escalation study in 24 MDD patients (28-day inpatient dosing at 40 mg once/twice/thrice daily; half-life ~17.4–20.5 hours; no serious adverse events; no significant hippocampal volume change at day 28 or 84), and a Phase 2 double-blind, placebo-controlled trial in 220 MDD outpatients (12 weeks at 40 mg or 80 mg daily) that missed its primary MADRS endpoint at both doses (p=0.22 and p=0.34, respectively), with some significant secondary/patient-reported benefits at 40 mg. A Phase 2b trial under the ALTO-100 designation (~300 adults, 34 US sites, 6-week double-blind) also failed to meet its primary MADRS endpoint (topline October 2024). Preclinical findings include improved motor/neurological deficits sustained to 24 weeks in a rat stroke model (oral dosing starting 6 hours post-MCAO; increased hippocampal/cortical MAP2 neurite outgrowth; in vitro OGD/R assays showed reduced cell death and upregulated BDNF/SCF), reversal of motor and cognitive impairments in an Angelman syndrome mouse model (with mild performance enhancement in wild-type mice), improved Barnes maze memory retention in a 5xFAD Alzheimer's mouse model (conference abstract), and prevention of peripheral neuropathy indices with increased hippocampal neurogenesis/synaptic markers/volume and protected long-term memory in mouse and rat models of type 1 and type 2 diabetes, alongside enhanced mitochondrial function in a type 2 diabetic rat model.
ISRIB and NSI-189 are both in the Cognitive category and may have overlapping mechanisms. Researchers should review both profiles carefully, understand the mechanisms of action, and monitor the relevant biomarkers when combining compounds in the same class. As always, consult a licensed healthcare provider before making any decisions about combining research compounds.
This platform provides informational tools only, not medical advice. This comparison is for educational purposes only. Consult a licensed provider.
Contraindications
Lab Testing
Key references
Disclosed Labs