We experienced a case of dentist who developed organic mood disorder following abuse of nitrous oxide for about two years. He showed manic symptoms of elated mood, flight of ideas, grandiosity, insomnia, persecutory delusions. There was no evidence of significant confusion or cognitive dysfunction . Past history revealed no previous major psychiatric disorders and no family history of psychiatric disorders. After discontinuation of nitrous oxide, he responded well to combined regimen including lithium and chrolpromazine and was discharged with improved condition. Nitrous oxide is one of anesthetic inhalants which is widely used in the operating room and dental practice. It is known as laughing gas which has an potential risk of abuse due to its psychedelic effects. Although lacking in the comprehensive study explaining the pattern of abuse, incidence of mental symptoms and mechanism of psychotomimetic effects, this case brings up the need for alertness for the potential diverse psychotic symtoms among the population who are exposed to possible misuse, especially the health professionals
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