Though a number of agents are available to treat acute manic episode but either because of their comparable efficacy to lithium or their dose related side effects, need for better agent is always being felt.

To study the efficacy and side effect profile of lamotrigine and its double blind comparison with lithium in acute mania.

We recruited 50 patients with diagnosis of manic episode according to DSM-IV and were divided into two groups. One group was given lamotrigine 100mg and another lithium 900mg in a double blind fashion. Patints were assessed subsequently on BPRS, CMRS,UKU side effect scale and CGI till next 28 days.

Subjects in lamotrigine group did not show much improvement at the end of 4th week as compared to lithium group. Side effect profile of both groups were in accordance with reported literature except that 61.9% patients in lamotrigine group showed weight loss. Also rash were found in only 3.5% of the lamotrigine group even with such a rapid escalation of the dose.

We found that lamotrigine is ineffective in case of acute manic episode when compared with lithium.