Rates of alcohol and other substance abuse ordependence disorders are substantially higher in persons with bipolar disordersthan in the general population, reaching approximately 61% in patients withbipolar I disorder. As a result, clinicians must be prepared to treatsubstance use disorders and bipolar disorder simultaneously. This presentationreviews data from the 4 published randomized, controlled trials ofpharmacotherapy (lithium, carbamazepine, valproate, and quetiapine) in thispopulation. Also reviewed are data from promising open-label, uncontrolledtrials. While the results of published research have been generally positiveand support the efficacy and tolerability of several agents from differentclasses in patients with a dual diagnosis of bipolar disorder and substanceabuse or dependence, more randomized, controlled research is needed.