Hsin-Chi Tsai, Shin-Yuan Chen, Sheng-Tzung Tsai, Hsiang-Yi Hung, Chun-Hung ChangBewernick et al. () demonstrated the antidepressant and antianxiety effects of deep brain stimulation (DBS) to the nucleus accumbens (NAc) in patients suffering from treatment-resistant depression. Deep brain stimulation has also been proposed in the management of treatment-refractory obsessive-compulsive disorder (OCD), and several clinical trials have shown positive results. The US Food and Drug Administration granted DBS a humanitarian device exemption for OCD in 2009 (). We report an ethnic Chinese male with OCD who developed hypomania after bilateral DBS in the ventral capsules, close to the NAc, and review hypomanic or manic cases in OCD trials.