What should paranoid patients do if they don't take medication

When patients with paranoid ideation refuse to take medication, they can be treated through psychological intervention, family support, behavior correction, alternative therapy, and compulsory medical treatment. Delusions of persecution belong to the spectrum disorder of schizophrenia, and patients often resist treatment due to shame or hallucinations.

1. Psychological Intervention

Cognitive behavioral therapy can help patients identify the irrationality of delusional content, and therapists guide patients to reflect on the objective basis of their victimized beliefs through gentle questioning. Supportive psychotherapy can establish trust relationships, discuss the necessity of medication in a non confrontational manner, and avoid directly denying patients' delusional experiences. The rehabilitation cases of patients in group therapy may reduce their sense of shame.

2. Family Support

Family members should receive education on mental illness knowledge and understand that patients' refusal to take medication is due to symptoms rather than intentional resistance. In the family environment, it is necessary to reduce provocative speech, replace preaching with companionship, and consult a doctor for feasibility when mixing medication into daily diet. Establishing a regular schedule and diet can help improve patients' treatment compliance.

3. Behavior correction

adopts a token based reward system, where patients are given their favorite activities as positive reinforcement when they cooperate with medication. Improving patients' interpersonal sensitivity through social skills training and reducing the perception of victimization exacerbated by interpersonal conflicts. Gradual desensitization can reduce patients' fear of medication, such as first taking pills and then trying small doses.

4. Alternative therapy

Long acting injections such as paliperidone palmitate can replace oral medication, injected once a month to avoid daily medication pressure. Physical therapy such as transcranial magnetic stimulation may improve delusional symptoms, but it needs to be combined with basic medication treatment. Nutritional supplements such as omega-3 fatty acids have an auxiliary effect on relieving mental symptoms, but cannot replace antipsychotic drugs.

5. Compulsory Medical Care

When a patient is at risk of self harm or injury, emergency hospitalization may be implemented in accordance with the Mental Health Act. Doctors will use rapidly acting injectable risperidone microspheres to control acute symptoms and conduct medication adaptation training during hospitalization. Regular follow-up visits by community health doctors can prevent drug relapse, and if necessary, joint intervention with public security departments can be carried out in the community.

Family members should record changes in the patient's symptoms and reasons for refusing medication, and bring past medication records for the doctor's reference when seeking medical treatment. Maintain a safe home environment and remove dangerous items that may be associated with delusions. Increase the intake of whole grains and dark vegetables rich in vitamin B family in diet, and avoid alcohol and caffeine stimulation. Regularly accompanying patients for low-intensity exercises such as walking may lead to an increase in endorphins in the body after exercise, which may improve mood and medication acceptance. If patients exhibit aggressive tendencies or extreme behaviors such as hunger strikes, they must immediately contact the psychiatric emergency department.