To the Editor: With the introduction of new antiviral agents, longevity has increased for many AIDS patients, along with the potential for AIDS wasting syndrome. Suggested remedies for this syndrome have included growth hormone, marijuana, appetite stimulants, ketotifen, exercise, anabolic steroids, and most recently, the testosterone patch. The effects of anabolic steroids on behavior have long been recognized and include mood lability, irritability, euphoria, insomnia, aggression, and sometimes delusions or hallucinations. Reports of behavioral effects of exogenous testosterone are limited and inconsistent (1). One study of intramuscular testosterone for male sexual dysfunction found irritability and uncharacteristic assertiveness in some patients (2), but there are no documented behavioral side effects of the testosterone patch. We report the first case of psychotic mania associated with testosterone patch administration.