To the Editor A recent study in JAMA Psychiatry reports improvement in treatment-resistant depression with liafensine in patients selected for having genotype GG for the ANK3 intronic variant rs12217173. The authors claim that liafensine failed to demonstrate efficacy in 2 prior large trials in non–biomarker-selected patients and cite 2 publications. However, 1 of these publications reported 2 trials in which liafensine had similar efficacy to duloxetine and escitalopram but failed to show superiority to them. The other publication cited has nothing at all to say about efficacy because it was a study of tolerability, pharmacokinetics, and pharmacodynamics of liafensine in a sample of healthy individuals. The present study is the first published trial, to my knowledge, in which liafensine has been compared with placebo, and there is no reason to think that similar efficacy would not be demonstrated in unselected patients.