Depends on the mod. If it is something small like the bonus merchants, you should not have to restart. But anything that makes any serious changes you probably do. Safest bet is to restart if you add a mod.
However, a piece of advice: don't download mods until you finish the game the first time through. The only things you should download and install are the official patch (obvious reasons) and the Baldurdash fixpacks (which fix errors in the game as well). This will allow you to enjoy the game as it was originally designed, then afterwards you can tinker with the game to your heart's content.
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[img]\"ubb/noncgi/smiles/new/ghoul.gif\" alt=\" - \" /><br /><br />\"The middle class pays all of the taxes, does all of the work.<br />The lower class exists just to scare the middle class.\"<br />-George Carlin
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