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Treatment with appropriate antipsychotic drugs may help the paranoid patient overcome some symptoms. Although the patient's functioning may be improved, the paranoid symptoms often remain intact. Some studies indicate that symptoms improve following drug treatment, but the same results sometimes occur among patients who receive a placebo, a "sugar pill" without active ingredients. This finding suggests that in some cases the paranoia diminishes for psychological reasons rather than because of the drug's action. Paranoid patients receiving medication must be closely monitored. Their fearfulness and persecutory delusions often lead them to refuse or sabotage treatment--for example, by holding the drug in their cheek until they are alone and then spitting it out.
