Chinese　herbal　medicines　possess　the　therapeutic　potential　for　mood　disorders.　This　double-blind,　randomized,　placebo-controlled　study　was　designed　to　evaluate　the　efficacy　and　side　effects　of　the　herbal　medicine　called　Free　and　Easy　Wanderer　Plus　(FEW?)　as　an　adjunct　to　carbamazepine　(CBZ)　in　patients　with　bipolar　disorders.　One　hundred　and　twenty-four　bipolar　depressed　and　111　manic　patients　were　randomized　to　treatment　with　CBZ　alone,　CBZ　plus　FEWP,　or　equivalent　placebo　for　12　weeks.　CBZ　was　initiated　at　300　mg/day　and　FEWP　was　given　at　a　fixed　dose　of　36　g/day.　Efficacy　measures　included　the　Hamilton　Rating　Scale　for　Depression,　Montgomery-Asberg　Depression　Rating　Scale,　Young　Mania　Rating　Scale,　Bech-Rafaelsen　Mania　Scale,　and　Clinical　Global　Impression-Severity　(CGI-S).　CBZ　monotherapy　produced　significantly　greater　improvement　on　manic　measures　at　week　2　through　endpoint　and　CGI-S　of　depression　at　endpoint　compared　to　placebo.　CBZ　monotherapy　also　yielded　significantly　higher　clinical　response　rates　than　placebo　on　bipolar　depression　(63.8%　vs.　34.8%,　p　=　0.044)　and　mania　(87.8%　vs.　57.1%,　p　=　0.0　12).　Compared　to　CBZ　monotherapy,　adjunctive　FEWP　with　CBZ　resulted　in　significantly　better　outcomes　on　the　three　measures　of　depression　at　week　4　and　week　8　and　significantly　greater　clinical　response　rate　in　depressed　subjects　(84.8%　vs.　63.8%,　p　=　0.032),　but　failed　to　produce　significantly　greater　improvement　on　manic　measures　and　the　response　rate　in　manic　subjects.　There　was　a　lesser　incidence　of　dizziness　and　fatigue　in　the　combination　therapy　compared　to　CBZ　monotherapy.　These　results　suggest　that　adjunctive　FEWP　has　additive　beneficial　effects　in　bipolar　patients,　particularly　for　those　in　depressive　phase.　(c)　2005　Elsevier　Ltd.　All　rights　reserved.