First Q to ask: Is this really a delusional disorder?
Look at the criteria with your very best Jeff Foxworthy inner voice. (You might be a redneck if…)
You might have a delusional disorder if….
Also, keep this in mind: Patients whose delusional beliefs are transient probably do NOT have a delusional disorder.
If paranoia and delusions seem to get worse around age 60-70, try to find a family member to collaborate.
Sadly, antipsychotics really don’t work for pure delusional disorder, but try them anyway. Goal is to reduce the distress.
Here’s an interesting factoid: Sometimes adding an antipsychotic makes it seem like they get worse – but it’s often because they were quietly delusional before, and now they are a bit more loose and verbal. Actually an improvement, so don’t change antipsychotics, it's working. Stay the course and cautiously increase the dose.
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