Three out of three randomized studies have found buspirone worthless for depression.  In contrast, the one worthless "open-label" report claimed that buspirone was absolutely wonderful.

Buspirone No Benefit as an SSRI Adjunct: In a 4-week DB PC study of 119 patients with major depressive disorders, who had failed to respond to citalopram or paroxetine after at least 4 week but were on these meds for an average of 200 days, 50% buspirone and 46% placebo responded. A randomized, double-blind, placebo-controlled trial of buspirone in combination with an SSRI in patients with treatment-refractory depression. No side-effects. Goteburg U, Landen M, Bjorling G, Agren H, Fahlen T. J Clin Psychiatry 1998 Dec;59(12):664-8

Small Open Buspirone Adjunct Trial Say Buspirone is Wonderful: In an extremely unreliable report of a 6-week "open-label" trial of treatment-resistant patients, the authors reported a 64% decrease in HAM-D, 63% "responders," and 79% of these successful during 4 months maintenance. Buspirone augmentation of antidepressant therapy. Dimitriou EC, Dimitriou CE. J Clin Psychopharmacol 1998 Dec;18(6):465-9; U Thessaloniki; Ed: Open trials are virtually worthless and should rarely ever be published.  Of course, the drug industry loves these reports and may have helped fund this report.  This report should never have been published since only double-blind trials can determine is any anti-depressant is better than placebo.  The editors of the Journal of Clinical Psychopharmacology were irresponsible in my opinion.

Buspirone No Added Benefit; Fluoxetine 40/d Faster than 20/d: A randomized open study of 120 major depressive disorder patients in Turkey found that patients assigned to buspirone plus fluoxetine actually responded more slowly (40 days average response time) compared to fluoxetine 20mg/d alone (33 days) or fluoxetine 40 mg/d alone (25 days). Faster response in depressive patients treated with fluoxetine alone than in combination with buspirone. Onder E, Tural U. J Affect Disord. 2003 Sep;76(1-3):223-7. Ed: While such open trials are definitely inferior, the fact that it was a randomized study is a redeeming factor and makes the study worth reading.

Buspirone No Benefit as SSRI Add-On: In a 102-patient 6-week DB PC study of major depressive disorder patients who had failed to respond to six week of fluoxetine or citalopram, those put of 10-30 mg b.i.d. of buspirone did no better than those on placebo. The authors try to tease out success by saying he found a significant difference for high MADRS depression score patients, but this is a totally inappropriate post-hoc conclusion. Patients with severe depression may benefit from buspirone augmentation of selective serotonin reuptake inhibitors: results from a placebo-controlled, randomized, double-blind, placebo wash-in study. Appelberg BG, Syvalahti EK, Koskinen TE, Mehtonen OP, Muhonen TT, Naukkarinen HH. University of Helsinki. J Clin Psychiatry. 2001 Jun;62(6):448-52;