Paranoid Personality Disorder centers on pervasive mistrust and suspiciousness, which are best addressed through psychotherapy. Psychotherapy gives a structured way to challenge and refine the patient’s interpretations of others’ motives, reduce defensive patterns, and improve interpersonal functioning. Techniques like cognitive-behavioral therapy help identify distorted beliefs and test evidence for and against hostile intentions, while psychodynamic or interpersonal approaches support the development of healthier patterns of relating to others. A strong, consistent therapeutic alliance is crucial because mistrust can make engagement with treatment itself difficult. Medications don’t target the core paranoia; they’re not the primary tool for this condition. They may be helpful if there are co-occurring issues such as anxiety, depression, or agitation, but they don’t replace the need for psychotherapy. So, the treatment of choice emphasizes psychotherapy over pharmacotherapy, with meds used only as adjuncts for comorbid symptoms.