The prescription of disulfiram for the treatment of alcohol dependence is common in clinical practice. This drug is an inhibitor of aldehyde dehydrogenase, which interferes in the alcohol metabolism by increasing blood levels of acetaldehyde and promoting an intense physical discomfort, thus reinforcing the need for alcohol withdrawal. Additionally, one metabolite of disulfiram is responsible for the inhibition of dopamine β-hydroxylase, and may potentiate psychotic or mood disorders even in the absence of personal or family history of psychiatric illness.

This paper aims to describe the clinical case of a 45 year old man with a history of alcoholism who presented the first manic episode after initiation of treatment with disulfiram and discuss, based on a literature review, the possible association between symptoms and treatment with this drug.