Jump to navigation Jump to search Cosmetic psychopharmacology, a term coined in by the psychiatrist Peter D. Kramer and popularized in his book Listening to Prozacrefers to the use of drugs to move persons from a normal psychological state to another normal state that is more desired or better socially rewarded — e. The comparison is with surgery in which the same intervention can be therapeutic as for reparative work on burn victims or cosmetic as in rhinoplasty for the enhancement of beauty in conventional terms.
Can there be a "cosmetic" psychopharmacology? Happiness has long been recognized as one of the central aims of life. It is not surprising that for centuries humans have been using mood-altering agents, such as alcohol and opiates, to aid in their pursuit of happiness.
Since the s, psychiatrists have treated mental illness with tricyclics and monoamine-oxidase inhibitors MAOIsand in fluoxetine was developed as the first selective serotonin reuptake inhibitor SSRI to combat depression. With rapid advances in neuroscience and biotechnology contributing new and powerful mood-controlling agents, questions regarding the acceptable prescription and use of such agents are prompting heated debate.
Such use raises questions about what qualifies as a cosmetic use of a psychoactive drug and whether physicians prescribing psychopharmaceuticals for cosmetic purposes are acting within the boundaries of their proper role as physicians. In a sophisticated discussion of cosmetic psychopharmacology, Pamela Bjorklund addresses these questions and comes to some surprising conclusions.
After examining the definitional boundaries of several crucial distinctions, such as health versus illness and clinical versus cosmetic, Bjorklund argues that many practices typically classified as cosmetic psychopharmacology are in fact either variations of legitimate clinical practices or clear examples of substandard care.
Finally, she examines nuanced cases where Cosmetic psychopharmacology classification is less clear. After discussing the nature of suffering as it relates to clinical illness rather than to existential crisis, she concludes that, even in the absence of a clear classification and underlying etiology for clinical Cosmetic psychopharmacology, treating subclinical cases of mental illness should be considered clinical, not cosmetic, psychopharmacology.
Introducing Cosmetic psychopharmacology Psychopharmacology Consider the following three cases adapted from examples presented by Sperry and Prosen : Luis is generally considered by his family and friends to be an outgoing and likeable man.
He is angry and irritable with his wife and children. Luis sees a psychiatrist and requests fluoxetine. Since childhood, Linda has been shy and despondent.
Regardless of changes in her life circumstances, her mood always reflects some degree of melancholia.
Friends and family characterize her temperament as negative and gloomy. After developing an interest in meditation, Linda realizes that her constant dysthymia interferes with her ability to meditate. She requests an SSRI to help alleviate the problem.
Larry considers himself to be healthy and fairly normal mentally and emotionally. Every now and then he has episodes of pessimism and melancholy, but he eventually returns to his normal temperament of quiet happiness.
He is neither gregarious nor diffident. Larry is a car salesman and he believes that fluoxetine will improve his personality and help him become more effective in his job.
Which, if any, of these examples constitutes the cosmetic use of an antidepressant? Bjorklund argues that this question hinges largely on how we differentiate the "clinical" from the "cosmetic," an especially blurry distinction in mental health. The etiology and biochemical markers of mental disorders are tenuously defined, and it is sometimes difficult to distinguish illness or disorder from normal mental states.
A normal depressed mood must be distinguished from clinical depression, and both must be differentiated from a melancholic temperament. This vague taxonomy is reflected in the diagnostic method used by most mental health professionals, which depends almost exclusively on observable psychological, physiological and behavioral signs, symptoms and clusters to identify and diagnose illnesses .
Thus, according to the original definition, all three of the examples above constitute the cosmetic use of an antidepressant; none of the individuals has a clinical diagnosis i. Working at the Margins Bjorklund challenges simplistic applications of the term cosmetic psychopharmacology.
She argues that the concepts of health and illness—and thus the concepts of cosmetic and clinical—are neither binary nor mutually exclusive; instead they lie on a complicated continuum where "health slides into illness and illness slips back into health almost imperceptibly" .
Bjorklund is hesitant to agree, because classifying this use as cosmetic "confer[s] some legitimacy to the practice…that it does not deserve" , referring to the social and medical acceptability that cosmetic surgery seems to have garnered in recent years.
Her visceral reaction to this use of an antidepressant is understandable. Readers should remember, however, that doctors treat other conditions that are not technically illnesses fairly regularly: Why is social and medical acceptability conferred upon these practices and a similar use of an antidepressant quickly labeled inept care?
Perhaps it is because Larry only wants the prescription to improve his sales. But what about the woman who wants a breast reduction because it will improve her career as a ballet dancer?
Would her request be refused as well? Not likely, because most physicians would see the physical and likely, the psychological benefits of such a procedure for a professional dancer.
Although she does not explicitly say, it is possible that Bjorklund believes this sort of care to be inept because it is ineffective and, thus, would fail to offer any benefit to Larry.
This claim is supported by recent research showing that, although antidepressants are effective in improving mood from a subnormal state to a normal state, they do not effectively raise mood from a normal state to an enhanced state.
If this were true, prescribing an antidepressant for someone like Larry would be clearly inept or substandard medical care.Cosmetic psychopharmacology, a term coined in by the psychiatrist Peter D. Kramer and popularized in his book Listening to Prozac, refers to the use of drugs to move persons from a normal psychological state to another normal state that is more desired or better socially rewarded — e.g., from melancholy toward assertiveness and confidence or from slower to quicker cognition.
Oct 07, · This unintended consequence may turn out to be a giant step toward a better life, but it may also be a leap into an abyss, one in which worries over cosmetic psychopharmacology will . Cosmetic psychopharmacology is defined as the use of psychiatric medications for certain patients who lacked any diagnosable psychiatric illness or condition.
1)T 2)F. "Cosmetic psychopharmacology" is a term of art invented by Peter Kramer in his book Listening to Prozac.
Prozac, of course, is an antidepressant, but what is so. Mental Health Meds as Social Drugs? Cosmetic Psychopharmacology? The term "cosmetic psychopharmacology" "Is that cosmetic?
It's not taking a pill to feel better than well, it is trying to. that all cosmetic psychopharmacology must destroy the relationship between happiness and experience, but whether all future mood-altering drugs will in fact do so is an empirical question.