Inclusion Criteria:
In order to be included in the study patient must meet criteria A, C, D, E, F, G plus any 1 of the 3 criteria listed in section B.
A. Patients meeting DSM-IV diagnosis of bipolar disorder, I or II
B.
- Patients meeting DSM-IV diagnostic criteria for a manic/hypomanic episode with the simultaneous presence of (or rapid alteration within minutes) of at least three DSM-IV depressive symptoms excluding psychomotor agitation or
- Patients meeting DSM-IV symptomatic criteria for a hypomanic/manic episode for a period of 2 days or longer, with the simultaneous presence of (or rapid alteration within minutes) of at least three DSM-IV depressive symptoms excluding psychomotor agitation or
- Patients meeting DSM-IV criteria for a depressive episode associated with at least three DSM-IV manic/hypomanic symptoms
C.MADRS of ≥14
D.YMRS of ≥ 14
E. Age 13years to 75 years
F. Male or female
G. Outpatient
Exclusion Criteria:
- illness precluding the use of LAM
- Alcohol/drug dependence in the past one month
- patients with a history of a rash on LAM
- CNS neoplasms, demyelinating diseases, degenerative neurological condition or active CNS infection
- history of seizure, known EEG with frank paroxysmal activity, known CT of brain showing gross structural abnormalities, cerebral vascular disease by history or structural brain damage from trauma
- patients currently taking LAM