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Considerations in the initial healthcare assessment for new arrivals
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Sleep problems are very common among forced migrants and are associated with depression, anxiety, nightmares, grief and fear. If sleep problems are discussed, ask further questions about mood and other psychological symptoms. The underlying problem should be addressed. Hypnotic medications should be avoided or used sparingly.
CBRN and the Trauma Victim
Published in Ian Greaves, Keith Porter, Jeff Garner, Trauma Care Manual, 2021
Ian Greaves, Keith Porter, Jeff Garner
The signs and symptoms of the hypnotic (or sedative) toxidrome include CNS depression (including coma), bradycardia, hypothermia and hypotension, respiratory depression and apnoea. The pupils will react variably. This toxidrome is caused by toxicants with GABA-a effects such as benzodiazepines, alcohols and barbiturates.
Psychotropic use in Australian aged care homes
Published in Bernadette McSherry, Yvette Maker, Restrictive Practices in Health Care and Disability Settings, 2020
The Royal Australian College of General Practitioners (RACGP) now recommends that older people presenting with anxiety should be treated initially with psychological therapies, then with antidepressants, if anxiety symptoms do not abate. Benzodiazepines should be used only intermittently, and chronic use avoided to lessen the risk of tolerance and dependence. In insomnia, the RACGP notes that although benzodiazepine treatment has shown statistically significant improvements in sleep in the short-term, ‘the magnitude of effect is small, and the benefits of these drugs may not justify the increased risk’. If hypnotics are to be used for treating insomnia, it is recommended that treatment is short-term (that is, not more than four weeks) and at the lowest possible dose (RACGP 2015).
Modern and traditional trance language: a comparison
Published in American Journal of Clinical Hypnosis, 2022
Sarah Karrasch, Johanna Alisa Jung, Suchithra Varadarajan, Iris-Tatjana Kolassa, Walter Bongartz
Hypnosis is considered as a state of focused attention belonging to altered states of consciousness (ASC) (Dietrich & Al-Shawaf, 2018). A hypnotic state is often accompanied by physiological, emotional, cognitive, and behavioral alterations (Elkins, Barabasz, Council, & Spiegel, 2015) which can be utilized for the treatment of a wide variety of physical and psychological conditions such as chronic pain and depression (Milling, Valentine, McCarley, & LoStimolo, 2018; Zech, Hansen, Bernardy, & Häuser, 2017). The hypnotic state is induced by the use of specific language, the suggestion. There are different kinds of hypnotic languages. The present study refers to the language of hypnosis or trance as it is termed in anthropological contexts (Bourguignon, 1979). Prominently, there are two types of trance languages. The first type termed as “direct trance language” was developed during 19th century (Bernheim, 1880) and this type of language mainly consists of direct suggestions by which an “authoritarian” hypnotist attempts to evoke experiences or behavior in the patient through direct suggestions. The following text is an example of direct suggestions:s You have become so deeply relaxed […] that everything that I put into your mind … will sink so deeply into the unconscious part of your mind … […] … and every feeling … that I tell you that you will experience … you will experience … exactly as I tell you. (adapted from Waxman, 1989, p. 219; italics ours)
Rethinking the use of hypnotics for treatment of insomnia in the elderly
Published in Expert Opinion on Pharmacotherapy, 2021
To date, hypnotics have been defined as drugs that shorten the time to sleep onset and increase total sleep time. I argue that the main target for a hypnotic, however, should be to improve daytime performance and general health. While this might entail lengthening the sleep period in some patients, the focus more generally should be on improving the quality of sleep, which is highly complex. Today, this mode of action to promote specific aspects of natural sleep is achieved only by the chronobiotic melatonin and orexin receptor antagonists. Melatonin with its highly time-dependent dosing improves coordination of circadian processes underlying the 24-h sleep–wake propensity. DORAs reinforce low orexin naturally occurring during sleep, which appears to promote various sleep-specific functions, resulting in improved daytime well-being and clearance of brain wastes such as amyloid, tau-, and synuclein-protein during sleep.
The neurochemistry of hypnotic suggestion
Published in American Journal of Clinical Hypnosis, 2021
David J. Acunzo, David A. Oakley, Devin B. Terhune
Here we reviewed current knowledge regarding the role of five neurochemicals in response to suggestions. These disparate bodies of research suggest that elevated dopamine, serotonin, GABA, and oxytocin and depleted glutamate are conducive to hypnotic responding. Multiple conflicting results have been reported regarding dopamine and oxytocin whereas links between hypnotic suggestibility and GABAergic agonism and glutamatergic hypofunction are relatively consistent. Nevertheless, the evidence bearing on a role for each of these neurochemicals in hypnotic responding is limited by numerous methodological shortcomings and outstanding questions regarding the neurochemical specificity of these effects. These preliminary results warrant further attention from studies applying more rigorous methodologies that control for competing interpretations and evaluate mediating hypothesized cognitive processes.