SGA-induced Metabolic Syndrome in Bipolar Youth

Inclusion Criteria: * DSM-IV-TR criteria for bipolar disorder, type I, manic or mixed episode * Baseline YMRS score \> 20 * Ages 10-17 years * Tanner scale stages III-V * No prior exposure to SGA medications * Fluent in English * Provision of written informed consent by a legal guardian and written assent by the subject * Manic or depressive symptoms do not result entirely from acute medical illness or acute intoxication or withdrawal from drugs or alcohol as determined by medical evaluation and rapid symptom resolution * If female and of child bearing potential, agrees to use one of the following method of birth control: complete abstinence from sexual intercourse, barrier (diaphragm or condom), or oral/injectable contraceptive. For Phase II, additional Inclusion criteria are * Receiving a stable therapeutic dose of quetiapine for a minimum of 1 week (i.e., patients who achieved remission (YMRS total score 7 during Phase I) * Not requiring concomitant use of antidepressant or mood-stabilizer medications (see Section C.4.c. Concomitant Medications). Exclusion Criteria: * IQ \< 70, as determined by The Wechsler Abbreviated Scale of Intelligence * Positive pregnancy test (to avoid teratogenesis) * A history of major cardiovascular or neurological illness * Any lifetime DSM-IV-TR substance use disorder (nicotine dependence is permitted) * A lifetime DSM-IV-TR diagnosis of any pervasive developmental disorder * Any history of a hematological disorder in themselves or a first-degree relative will be excluded (since omega-3 fatty acids may be associated with anti-thrombotic effects). Similarly, concomitant use of medications with anticoagulant effects (e.g. aspirin) will be prohibited * Allergy to fish/seafood; 8) Currently taking omega-3 fatty acid supplements