Questions about meds and paranoia

My boyfriend has been on Olanzapine and it was working very well when we first started the medication. He has started to become paranoid and hallucinating again. We do have a doctors appointment to get a med check friday. Things he is saying and I am not sure how to go about addressing them because I have read their thoughts are very real so I dont want him to not trust me even more then what it seems at times. When I try to talk to him about taking his meds ( because when he starts acting this way he doesnt want to take them.) he will say things why should I trust you you have set me up before. He also will say things like I am cheating on him and am trying to get him jumped. I usually just try to change the subject but sometimes he will get mad because I wont answer the questions. He is not violent at all I can just tell he is very confused and wants to know the answers. How do I address this situation? When we go in for his med appointment will they once again switch his meds or will they just give him a higher millagram?

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@vichenny I go to all of my adult sons med check appointments but when I have a concern about him if I talk about it openly to the psychiatrist it will set my son off and he will spend he next 2 days telling me how I persecute and lie about him…SO to bypass all of that I write a detailed note (ahead of the appointment) and have it put in the doctor’s office mailbox (internally) that explains my concerns and the need to not create open confrontation during the session…that way she knows what is going on but I don’t look like I am “ratting him out” during the session and we can keep the peace, Hopefully during the session the doctor will ask whatever questions she or he needs to ask (based on your note) to determine if a medicine change or increase is needed.

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