Ethical paradigms of cosmetic psychopharmacology and overmedicalisation

Abstract

Cosmetic psychopharmacology (CP) encompasses the use of psychotropic medications not only for the treatment of severe psychiatric disorders, but also for the management of subthreshold psychiatric symptoms and the enhancement of an individual's emotional resilience and overall functioning.

CP is often criticized, particularly for promoting the medicalization of mild or subclinical psychiatric symptoms. Another major concern is the challenge it poses to accepting human imperfections, potentially normalizing perfectionist standards. In a society where being “normal” is increasingly associated with being happy, outgoing, and energetic, CP may fuel the use of psychotropic drugs to create identities that fit these socially endorsed ideals. At the same time, the fact that people may choose CP freely reflects their right to autonomy. Yet, given the unequal and limited access to CP, significant ethical issues arise around fairness and equity. Some individuals using CP become not only more social, cooperative, and active but also appear more socially appealing, forming stronger relationships as a result.

In summary, failing to establish clear boundaries for CP use risks framing subthreshold symptoms—which could be effectively managed with psychosocial interventions—as medical issues. Additionally, the ambiguity surrounding the scope of psychopharmacology could lead to profound shifts in how individuals perceive themselves and engage socially. Without clear guidelines distinguishing therapeutic from cosmetic use of psychotropic drugs, psychosocial interventions may be unnecessarily delayed. From a preventive standpoint, intervention may be justified when there is strong evidence that subthreshold symptoms could progress to clinical conditions warranting active treatment. However, reducing this multifaceted biopsychosocial process to a simple autonomy argument limits the depth of the conversation. Therefore, a thorough evaluation of the potential risks associated with CP use is essential.