Hi GoatKing. I don't have special knowledge about paranoia, so I wasn't sure if I should comment here. I used to have a friend, though, who suffered from paranoid delusions. He has since moved away from the state where I live. He got so that he would talk to me quite a bit about what was going on with him.

I would notice, and he would say, that he would do much better for a while then things would get worse again. He used to keep a diary of what was going on, just for a record of frequency with which he was having problems and to see what types of things he was thinking.

The intensive outpatient program sounds like a good idea if you can manage it. You'd be able to report symptoms when you have them and get faster meds adjustment.

I don't know if you want to share the details of which medications you take and what dosages. People who take similar medications might have suggestions or ideas.