Many patients with sensitive paranoia are distrustful of psychotropic medication for the following 3 reasons:
1. They believe that psychotropic drugs are going to change their personality
In reality, patients with sensitive paranoia respond well to psychotropic drugs at appropriate doses. High doses are unnecessary: conventional doses for antidepressants and low doses for neuroleptics. The sensitive paranoia patient’s body generally very easily tolerates these doses of medication, which allow them, on the contrary, to easily regain their true personality while avoiding delusional episodes.
2. They believe that the need for medication classifies them as mentally ill and therefore devalorizes them
In fact, patients with sensitive paranoia have strong values: they are sensitive, ambitious, rigorous, with a deep sense of moral and ethical values. By taking treatment to avoid delusional episodes, they can largely out-perform the very great proportion of the population which does not take medication.
3. They believe that medications are not useful, as they can sometimes spend many months without medication without any problems.
As we have seen in relation to paranoid neurosis in the section on Clinical features, repeated acute delusional episodes must be absolutely avoided, as the patient’s body becomes accustomed to the delusions and delusional episodes are triggered increasingly easily. Treatment prevents the emergence of new delusions and gradually controls the disease. Introduction of medication at the beginning of a delusional episode would be too late, as the beneficial effect is generally only observed after a period of 10 to 15 days (see Medications).
It is therefore essential to take treatment regularly for as long as prescribed by your doctor, which may be several years.