• Examine the efficacy of the combined pharmacotherapy treated group (valproate plus naltrexone)in decreasing the quantity and frequency of alcohol consumption,facilitating abstinence and decreasing relapse in patients with comorbid bipolar disorder and al [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  

• Determine whether primary vs. secondary alcoholism, bipolar subtype (depressed vs. manic/mixed subtype,and the presence of other substance use disorders moderate the association between treatment and alcohol use outcome. [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  

Bipolar disorder has the highest rate of association with alcohol and other substance use disorders. This complex clinical presentation is asociated with severe disabilities,morbidity and heightened risk for suicide. There is a significant gap in our knowledge regarding effective treatment interventions for this high risk clinical population. This proposal will test the efficacy of a promising pharmacological approach for the treatment of comorbid alcohol dependence and bipolar disorder. We propose a randomized, double blind, placebo controlled 12-week trial to test the efficacy of valproate plus naltrexone vs. valproate alone in decreasing alcohol use and stabilizing mood symptoms among patients with comorbid alcohol dependence and bipolar disorder. All participants receive supportive psychosocial treatment.