This article presents the case of a 50-yr-old man with HIV infection & a history of hospitalization for depression with suicidality, as well as mania in association with fluoxetine & bupropion treatment. The case shares several features of 1 previously reported by Zubieta & Demitrack but important differences that distinguish the 2 cases are also noted. The authors conclude that further study regarding the use of antidepressant agents in the depressed state of bipolar illness is needed.