Quetiapine for Bipolar Disorder and Alcohol Dependence

Inclusion Criteria: * Outpatients with a diagnosis of bipolar I or II disorder, depressed or mixed phase on the Structured Clinical Interview for the Diagnostic and Statistical Manual for Mental Disorders (SCID) and confirmed by interview with PI or co-I. * Current diagnosis of alcohol dependence. * Alcohol use (by self-report) of at least 15 drinks in the 7 days prior to baseline. * Currently taking a mood stabilizer defined as lithium, divalproex/valproic acid, oxcarbazepine, or lamotrigine at a stable dose for \> 14 days. * Men and women age 18-65 years old. * English or Spanish speaking. Exclusion Criteria: * Bipolar disorders other than bipolar I or II (e.g., not otherwise specified or cyclothymic disorders) based on the SCID and confirmed through clinical assessment by PI or co-I. * Baseline Young Mania Rating Scale (YMRS) score \> 35 or Hamilton Depression Rating Scale (HRSD) 17 score \> 35. * Current clinically significant psychotic features (hallucinations, delusions, disorganized thought processes). * Evidence of clinically significant alcohol withdrawal symptoms defined as a Clinical Institute Withdrawal Assessment (CIWA-AR) score of \> 8. * History of hepatic cirrhosis or baseline AST or ALT \> 3X upper limit of normal or other clinically significant findings on physical or laboratory examination. * Mental retardation or other severe cognitive impairment. * Prison or jail inmates. * Pregnant or nursing women or women of childbearing age who will not use oral contraceptives, abstinence, or other acceptable methods of birth control during the study. * Antipsychotic therapy within 14 days prior to randomization. * Current carbamazepine or benzodiazepine therapy. * Current treatment with medications shown to reduce alcohol consumption (naltrexone, acamprosate, disulfiram, or topiramate) in large randomized, controlled trials. * Initiation of antidepressants or mood stabilizers or psychotherapy within past 2 weeks. * High risk for suicide, defined as any suicide attempts in the past 3 months or current suicidal ideation with plan and intent. * Intensive outpatient treatment for substance abuse (AA, NA meetings, or other 12-step programs or weekly psychotherapy that started at least 14 days prior to randomization will be allowed). * Current treatment with ketoconazole, itraconazole, erythromycin, or nefazodone. * Severe or life-threatening medical condition (e.g., congestive heart failure, terminal cancer) or laboratory or physical examination findings consistent with serious medical illness (e.g., severe edema, atrial fibrillation, dangerously abnormal electrolytes). * Diabetes mellitus by history or suspected from baseline blood sugar. * History of cataracts or suspected cataracts on ophthalmic exam * History of seizure disorder of any etiology; if a subject develops a seizure episode, s/he will be discontinued from the study.