The authors report on a 42-year-old female inpatient with bipolar I di
sorder, whose dysphoric mania responded rapidly and completely while h
er antimanic medication (lithium, carbamazepine, clozapine, haloperido
l and clonazepam) was supplemented by 20 mg of paroxetine daily. The p
ractical and theoretical importance of this case is briefly discussed.