How is delusional disorder treated?
Treatment for delusional disorder most often includes medication and psychotherapy (a type of counseling); however, delusional disorder is highly resistant to treatment with medication alone. People with severe symptoms or who are at risk of hurting themselves or others might need to be in the hospital until the condition is stabilized.
Psychotherapy is the primary treatment for delusional disorder. It provides a safe environment for patients to discuss their symptoms while encouraging healthier and more functional attitudes and behaviors.
Psychosocial treatments. Various psychosocial treatments can help with the behavioral and psychological problems associated with delusional disorder. Through therapy, patients also can learn to control their symptoms, identify early warning signs of relapse, and develop a relapse prevention plan. Psychosocial therapies include the following:
- Individual psychotherapy can help the person recognize and correct the underlying thinking that has become distorted.
- Cognitive-behavioral therapy (CBT) helps the person learn to recognize and change thought patterns and behaviors that lead to troublesome feelings.
- Family therapy can help families deal more effectively with a loved one who has delusional disorder, enabling them to contribute to a better outcome for the person.
Medications: The primary medications used to attempt to treat delusional disorder are called anti-psychotics. Medications include the following:
- Conventional antipsychotics, also called neuroleptics, have been used to treat mental disorders since the mid-1950s. These medicines work by blocking dopamine receptors in the brain. Dopamine is a neurotransmitter believed to be involved in the development of delusions. Conventional antipsychotics include chlorpromazine (Thorazine®), fluphenazine (Prolixin®), haloperidol (Haldol®), thiothixene (Navane®), trifluoperazine (Stelazine®), perphenazine (Trilafon®) and thioridazine (Mellaril®).
- Newer medications — called atypical antipsychotic drugs — appear to be more effective in treating the symptoms of delusional disorder. These medications work by blocking dopamine and serotonin receptors in the brain. Serotonin is another neurotransmitter believed to be involved in delusional disorder. These drugs include risperidone (Risperdal®), clozapine (Clozaril®), quetiapine (Seroquel®), ziprasidone (Geodon®) and olanzapine (Zyprexa®).
- Other medications that might be used to treat delusional disorder include tranquilizers and antidepressants. Tranquilizers might be used if the person has a very high level of anxiety and/or problems sleeping. Antidepressants might be used to treat depression, which often occurs in people with delusional disorder.