Disulfiram (Antabuse) is used extensively in the management of alcoholism and, although mild psychiatric symptoms are quite common side-effects of treatment with this drug, psychotic reactions rarely occur. With the high doses of disulfiram used in earlier days, the incidence of 'psychosis' was estimated at 2 - 20%. A more recent review suggests that the incidence is far lower and that the 'psychosis' described in many cases consisted of mild psychiatric disturbances, such as anxiety and sedation, as well as a more florid psychosis or an organic brain syndrome. Of the 52 cases reported in the English-language literature, only 9 reflect psychotic reactions to disulfiram, the remainder being schizophrenic or developing a picture of organic brain syndrome. We report a case because of its implications.