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Gilbert's Syndrome is a benign familial condition in which unconjugated hyperbilirubinemia occurs in the absence of structural liver disease or hemolysis. Phenothiazines and tricyclic medications are often withheld in patients with preexisting liver disease. The authors present four patients with Gilbert's Syndrome and concurrent psychiatric illness. Administration of phenothiazine antipsychotics or tricyclic antidepressants proved beneficial and produced no adverse effects on hepatic function. The authors discuss clinical aspects of Gilbert's Syndrome in psychiatric patients and conclude that phenothiazine antipsychotic medication should not necessarily be withheld from these patients.