Aversive agents: Think twice. A case report on disulfiram-induced mania

We present a case of disulfiram-induced mania in a patient with both alcohol use disorder (AUD) and psychostimulant use disorder (PUD), without a history of psychosis or mania. This acute presentation may be linked to the increased dopamine levels caused by disulfiram metabolism. Our patient developed manic symptoms 10 days after starting disulfiram, prescribed to treat the AUD. It should be noted that the symptoms resolved rapidly after disulfiram cessation during hospitalization. Disulfiram use is an effective treatment for alcohol dependence. However, there are safety concerns associated with it and it requires close monitoring, particularly in patients with a history of mania, psychosis, or psychostimulant use.