Clinical Medication Development for Bipolar Disorder and Alcohol Use Disorders

Inclusion Criteria: * Outpatient men and women age 18-70 years old with bipolar I or II disorder or schizoaffective disorder (bipolar type) * English or Spanish speaking * Current diagnosis of alcohol use disorder with at least moderate severity (DSM-5 terminology) * Alcohol use of at least an average of 28 drinks a week if male or an average of 21 drinks per week if female and an average of 3 drinking days a week in the 28 days prior to intake * Current mood stabilizer therapy (defined as lithium, lamotrigine, carbamazepine, oxcarbazepine or an atypical antipsychotic) with stable dose for ≥ 28 days prior to randomization or valproate/divalproex at a stable dose for ≥ 90 days (longer period due to data suggesting valproate may decrease alcohol use in BPD) * Diagnosis of substance use disorder other than alcohol, caffeine or nicotine is allowed if 1) alcohol is the self-identified substance of choice and 2) severity of other substance use disorder is ≤ moderate Exclusion Criteria: * Mood disorders other than bipolar I or II disorders or schizoaffective disorder bipolar type (e.g. bipolar NOS, cyclothymic disorders, schizophrenia, schizoaffective disorder depressive type, or unipolar depression based on the SCID); other disorders (e.g. anxiety, will be allowed) * Baseline HRSD17 or YMRS scores ≥ 35 to exclude those with very severe mood symptoms at baseline * Evidence of clinically significant alcohol withdrawal symptoms defined as a CIWA-Ar score of ≥ 10 * Current (last 28 …