How is delusional disorder treated?

How is delusional disorder treated?

Treatment for delusional disorder most often includes psychotherapy (talk therapy) and medication, but delusional disorder is highly resistant to treatment with medication alone.

People with delusional disorder often don’t seek treatment for the condition on their own because most people with delusional disorder don’t realize their delusions are problematic or incorrect. It’s more likely they’ll seek help due to other mental health conditions such as depression or anxiety.

People with severe symptoms or who are at risk of hurting themselves or others might need to be admitted to the hospital until the condition is stabilized.

Psychotherapy for delusional disorder

Psychotherapy is a term for a variety of treatment techniques that aim to help people identify and change troubling emotions, thoughts and behaviors. Working with a mental health professional, such as a psychologist or psychiatrist, can provide support, education and guidance to the person and their family.

Through therapy, people with delusional disorder can learn to manage their symptoms, identify early warning signs of relapse and develop relapse prevention plans. Types of psychotherapy include:

• Individual psychotherapy: This type of therapy can help a person recognize and correct the underlying thinking that has become distorted.
• Cognitive behavioral therapy (CBT): This is a structured, goal-oriented type of therapy. A mental health professional helps people take a close look at their thoughts and emotions. They’ll come to understand how their thoughts affect their actions. Through CBT, they can unlearn negative thoughts and behaviors and learn to adopt healthier thinking patterns and habits.
• Family-focused therapy: This therapy can help people with delusional disorder and their families. This treatment involves psychoeducation regarding delusional disorder, communication improvement training and problem-solving skills training.

Medications for delusional disorder

The primary medications used to help treat delusional disorder are called antipsychotics (neuroleptics). Medications include the following:

• First-generation (“typical”) antipsychotics: Healthcare providers have used these medications to treat mental health conditions since the mid-1950s. These medicines work by blocking dopamine receptors in your brain. Dopamine is a neurotransmitter believed to be involved in the development of delusions. First-generation antipsychotics include chlorpromazine (Thorazine®), fluphenazine (Prolixin®), haloperidol (Haldol®), thiothixene (Navane®), trifluoperazine (Stelazine®), perphenazine (Trilafon®) and thioridazine (Mellaril®).
• Second-generation (“atypical”) antipsychotics: These newer antipsychotics are also effective in treating the symptoms of delusional disorder. They work by blocking dopamine and serotonin receptors in your brain. These drugs include risperidone (Risperdal®), clozapine (Clozaril®), quetiapine (Seroquel®), ziprasidone (Geodon®) and olanzapine (Zyprexa®). These medications are usually better tolerated than first-generation antipsychotics.

Other medications that healthcare providers might prescribe to treat delusional disorder include anxiolytics and antidepressants. Anxiolytics might help if the person has a very high level of anxiety and/or problems sleeping. Antidepressants can help treat depression, which often occurs in people with delusional disorder.