Talk:MDMA/Archive 5

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Article Edit

I don't want to register an account as I very rarely edit Wikipedia, however, regarding the following line:

In 2010 the BBC reported that use of MDMA had decreased in the UK in previous years. This is thought to be due to increased seizures and decreased production of the precursor chemicals used to manufacture MDMA. The availability of legal alternatives to MDMA such as mephedrone is also thought to have contributed to its decrease in popularity.[24]

Mephedrone is no longer legal in the UK so this should be reworded to remove legal. Mephedrone usage is common and is frequently unknowingly used (swapped out in place of real MDMA) as well as recreationally used on its own. An excellent link describing usage of Mephedrone in the UK (and its replacement of MDMA in tablets): http://scientopia.org/blogs/drugmonkey/2010/09/19/mephedrone-4-methylmethcathinone-appearing-in-ecstasy-in-the-netherlands/

Hopefully somebody can edit this article for me :)

72.52.102.5 (talk) 02:11, 30 December 2010 (UTC)

Done.24.98.1.233 (talk) 00:59, 1 January 2013 (UTC)

The section which says " Although one study[61] argues that MDMA itself causes fluid retention and increased body temperature, while alcohol is a diuretic and lowers the body temperature. Therefore, it is possible that a small amount of alcohol may help counteract a few of the adverse effects of MDMA." Should be removed or placed next to the following information (with rewording); although it refers to a study which shows that alcohol may limit the side effects of MDMA the general scientific concensus shows that it is best to rehydrate with water or isotonic drinks, in order to rehydrate the body. Alcohol will obviously only further dehydrate the body.

This i potentially dangerous misinformation and i think it should be changed. —Preceding unsigned comment added by 195.195.88.80 (talk) 13:49, 27 April 2011 (UTC)

Merge or Link With Ecstasy (Drug)

I was looking for info on ecstasy and when I opened the ecstasy page it read as a sales pitch for ecstasy, no facts or harmful effects I didn't even know the MDMA page existed, the only link to this page is a link to Methylenedioxymethamphetamine, which many people (including I) will overlook as just a link to some chemical compound. The only things on the ecstasy page are a description of the positive effects, the ways to mitigate negative effects (without naming them), a list of about 25 substances that could be in ecstasy tablets, and a reference to a study that says how harmless ecstasy is.

Because of the lack of information and NPOV, I suggest that ecstasy (drug) become a redirect to MDMA. Maybe copy over the harm reduction section, but there are no sources on any of the claims there, so I suggest rewriting that into a new section as well.

A temporary solution would be to put at the top of the page a link to the MDMA page something like "For the active ingredient in ecstasy, see MDMA." I don't know how to do this, otherwise I would.

What do you all think? Holman.mike (talk) 03:12, 30 September 2009 (UTC)

On a related note Talk:Ecstasy (drug) is erroneously redirecting here. I will amend this. Nick Cooper (talk) 13:22, 30 September 2009 (UTC)

It's not "erroneously" redirecting here: El3ctr0nika (talk · contribs) forked the article in August, but didn't fork the talk page. I've re-merged and pinged the user. Chris Cunningham (not at work) - talk 15:18, 30 September 2009 (UTC)

I added more links on the Ecstasy (Drug) page to MDMA, including at the top of the page. Tova Hella (talk) 19:25, 30 September 2009 (UTC)

I restored the redirect pending a consensus being reached otherwise. --John (talk) 14:00, 1 October 2009 (UTC)

Proposed Ecstasy Sub-heading

When I saw that ecstasy (drug) redirected to MDMA I was surprised to see that there used to be two separate articles which were merged into one. I would have thought the decision would go the other way as ecstasy can have a very different meaning from MDMA. I understand that some effort is made to highlight this in the opening section, but I still think that the article could do with more explanation as to the difference in terminology. I am therefore proposing that we have a subheading titled Ecstasy explaining what ecstasy is and how it is not necessarily the same thing as MDMA. Apart from anything else it seems like important safety information. If people support this idea I will make a sandbox mock-up of how I think the article should look and we can decide whether or not to edit the article. Thank you for any feedback Gul e (talk) 19:30, 29 June 2012 (UTC)

After effects

I'm changing the heading "Rebound / withdrawal" to "After effects". We could also use "Subacute effects", as "subacute" means between acute and chronic, but "after effects" is more common language. "Subacute" and "after" are the terms most commonly used in research articles for effects occurring within a week of MDMA use. Both terms are neutral, unlike "rebound" or "withdrawal".

"Rebound" implies that after effects are the opposite of acute MDMA effects. This up/down ecstasy/agony model is overly simplistic. Many after effects of MDMA are just a continuation of the acute side effects, and some may be a consequence of sleep deprivation (mood, Pirona and Morgan 2009 J Psychopharmacol) or physical activity (muscle ache).

"Withdrawal" implies that if people just continued taking MDMA repeatedly they would not experience these effects. Tova Hella (talk) 19:19, 19 November 2009 (UTC)

I edited the uncited sentence regarding chronic depression after use being attributable to brain damage. That's rather egregious misinformation if untrue so it definitely needs a citation. 67.233.200.190 (talk) 03:45, 6 January 2010 (UTC)

Side effects

I've called for improved references in the Side effects and After effects sections. The first one forthcoming was - Lester SJ, Baggott M, Welm S, Schiller NB, Jones RT, Foster E, Mendelson J (2000). "Cardiovascular effects of 3,4-methylenedioxymethamphetamine. A double-blind, placebo-controlled trial" (PDF). Annals of Internal Medicine. 133: 969-973.{{cite journal}}: CS1 maint: multiple names: authors list (link)

I suggest that it's somewhat dubious to add reference to a study which only speculates - "preexisting cardiovascular conditions could increase cardiovascular risk compared with the carefully screened healthy volunteers in our study" - in support of the contention that both tachycardia and hypertension are "most common adverse side effects reported by users".

--SallyScot (talk) 20:26, 21 November 2009 (UTC)

Draeco reverted the dubious tags 21:59, 21 November 2009. I've since updated so the whole section is referenced.

--SallyScot (talk) 23:24, 21 November 2009 (UTC)

Sexual Dysfunction

I removed the following text from the article, because it implied that it was supported by references elsewhere in the article, but such references were absent. Please re-add the material, citing Reliable Sources if it is in fact accurate.

(along with paradoxical sexual dysfunction (see below))

Thanks, Vectro (talk) 23:18, 27 November 2009 (UTC)

Globalize

I have marked this article as in need of globalization. It has alot of information that is not specific to any country - ie, the chemistry section. BUT, whenever it is possible for the shift to focus on a country, it focuses on either the US or UK.

The sections that in my opinion are most in need of work are "history", "legal issues", and "health concerns" - within health concerns, specifically the sub-sections "harm assessment" and "recommendation to downgrade" - it seems unbalanced to have so much detail on specific actions and assessments by health and government authorities in the UK, and no detail relating to any other countries.

Minor mention is made of europe (europe as a whole- not of any specific countries other than the UK). For instance, in the recreational use section, ecstasy prices are given in euros and US dollars (no other countries or currencies mentioned).

This article gives a strong impression that ecstasy is only used in the US and Europe (mainly the UK) - maybe someone could research a new section detailing the history and extent of MDMA use worldwide- or the "recreational use" section could be substantially expanded to include this information?

Brunk500 (talk) 16:55, 14 December 2009 (UTC)

Biased by ectasy users

So ecstasy is perfectly fine to use? I get the impression in this article that it is pro-ecstasy use. I find this disturbing as we all know that teenagers would refer to this Wikipedia page with more faith than what their teachers and parents are telling them (maybe justly so). Still I really think this article should put more emphasis on the negative long term effects of ecstasy. So what if there is a Chinese study on ecstasy which contradicts another study which finds ecstasy harmful? What we need is convergence not to put a chronology of every pro-ecstasy article and every anti-ecstasy article.

Lets face it doing this drug once or twice will not ruin your life. Still this article comes off as too benevolent because I know people who have abused ecstasy and there are cognitive impairments. This may be just anecdotal but I think many people would agree long term ecstasy abuse will destroy your life as easily as long term alcohol abuse.

I am just concerned this article is written by ecstasy users for ecstasy users. It's a closed circuit and if anyone finds a study that shows the negative effects of ecstasy the editors will find another study which counters it. —Preceding unsigned comment added by 206.108.31.35 (talk) 17:17, 16 December 2009 (UTC)

How about you read the entire article, it is NOT being passed off as a benign drug. And I and other drug users (hopefully) know that isn't the truth. If you have problems with specific wording please do say so. C6541 (T↔C) 17:20, 16 December 2009 (UTC)

I also find parts of the article biased, putting ecstasy in what is probably a too positive light. As for specific suggestions for improvements, take a look at the 'effects' section. It is a long list of unsourced claims with positive rings to them. I would say that all these claims should be backed up by reliable sources as per Wiki rules, or be removed. Pubmed gives a heap of documentation, such as [[1]]. Even with such sources, the positive short-term effects are given undue weight. --EthicsGradient (talk) 14:40, 18 February 2010 (UTC)

Check out erowid.org for good sources. And often the negative side effects come at high doses, so while I think the list should be weighted better it should also reflect this fact. AC (talk) 18:08, 11 May 2010 (UTC)

I've briefly reviewed erowid.org. It does seem to be a decently run web-site, but it is in itself very positive about drug-use. This is okay, but compared to statements from peer-reviewed literature it should not be given too much weight. If a statement found at erowid is contradicted by peer-reviewed literature, it would have to give way to expert-generated, quality-controlled knowledge. EthicsGradient (talk) 15:27, 30 May 2010 (UTC)

If i may, illegal drugs are an area where widespread misinformation is the norm. Not only the government, but drug trafficers and users informed by heresay spread information that is misleading, unsubstantiated, or intentionally lies/propoganda. Therefore, saying that this article is "too positive" or "too harsh" needs to be backed up by reliable scientific sources - NOT your personal opinions. It should not be surprising that this article doesn't fit your view of the world. 98.207.159.144 (talk) 22:15, 31 May 2010 (UTC)

I dissagre, i think if anything this is biased against use of ecstacy, due to the large amount of information of adverse effects compared to how rare these actual effects are. I suggest that an incidence rate for each side effect should be included. —Preceding unsigned comment added by 195.195.88.80 (talk) 13:32, 27 April 2011 (UTC)

Ethics and AC, please see Talk:Erowid where I describe how Erowid spread blatant misinformation about the nature of marijuana and Columbian Cartels. Not a reliable or informed source. --IronMaidenRocks (talk) 11:48, 29 February 2012 (UTC)

I disagree. I believe that the article puts MDMA in a positive light COMPARED TO WHAT YOU KNEW BEFORE because of all the misinformation put out by the media. The reality is that virtually all neutral unbiased objective studies show that MDMA is benign in the long-run, and some even suggest that it encourages self-growth. Please, most anti-ecstasy articles use Ricaurte's study as a reference. It has been proven that at some point in his study he switched to methamphetamine, he used exaggerated amounts of the drug (around a few thousand doses every injection) and has himself retracted from the experiment due to it being so controversial. He also claimed completely false finds, such as the alleged link between MDMA use and Parkinson's disease http://www.nytimes.com/2003/12/02/science/research-on-ecstasy-is-clouded-by-errors.html?pagewanted=all&src=pm.Citations about MDMA in general (There are PLENTY more from where this came from): http://www.erowid.org/chemicals/mdma/mdma.shtml http://dancesafe.org/drug-information/ecstasy-slideshow — Preceding unsigned comment added by 84.111.208.28 (talk) 11:11, 15 March 2012 (UTC)

Ecstasy user bias

So ecstasy is perfectly okay to use? I find that this article is too benevolent to ecstasy. I think ecstasy users are trying to make this article pro-ecstasy use. For every study that finds anything negative about ecstasy the editors will find a Chinese study which counters it. This leads nowhere.

This article is created by ecstasy users for ecstasy users. I find this distrubing as teenagers may use this article to inform their decision to use the drug or not. I will keep editing this talk page until this discussion goes somewhere. —Preceding unsigned comment added by 24.71.136.35 (talk • contribs) 05:14, 17 December 2009

Your vague generalisations are not very helpful. Could you please identify the specific parts of the text you disagree with, and why? Nick Cooper (talk) 14:53, 17 December 2009 (UTC)

Not sure which sections your referring to but certainly the section heading "Beneficial effects" is problematic. Principally because it is not NPOV WP:NPOV but also because the reference it cites does not use the word "Beneficial" at all. I will change this to "Subjective effects" in line with the majority of MDMA-related literature on psychological and physiological efects of the drug.--Amaher (talk) 08:15, 27 January 2010 (UTC)

because it causes brain damage in people. —Preceding unsigned comment added by 64.38.64.153 (talk) 18:26, 24 January 2010 (UTC)

So does alcohol. Even water can cause brain damage. The question is how, why, and can it be avoided. 98.207.159.144 (talk) 22:10, 31 May 2010 (UTC)

• As a medical student I have been taught on the wards and in pharmacology that ecstasy is an extremely dangerous substance that can induce amphetamine psychosis. I can't help feeling while reading this article that it's biased toward portraying ecstasy as much less harmful than it is. —Preceding unsigned comment added by 87.69.68.12 (talk) 13:44, 17 July 2010 (UTC)

New content with references are welcome. - Steve3849^talk 14:00, 17 July 2010 (UTC)

Yet stimulant pyschosis does not mention MDMA, although it does methylphenidate and even caffeine. Not saying that MDMA can't lead to it, but clearly it's not a particularly common effect. Nick Cooper (talk) 17:01, 17 July 2010 (UTC)

Problems With Neurotoxicity

I have a few problems with the neurotoxicity section. First and foremost, "A number of studies [84] have demonstrated lasting serotonergic changes occurring due to MDMA exposure". This quote is completely unsubstantiated. "A number of studies" must be backed up by more than one study. I'm changing that immediately because it is not factually supported. I will change it to indicate that only one study has shown this. Secondly, this study was carried out by Ricuarte, whose work has been marginalized recently. The main problem is internal variance in his data that showed (almost certainly mistakenly) people in the same group (both in the non-user and user sections) has up to 10 times more serottonin than one another. This is biologically absurd, and makes any findings highly suspect. Even ABC, a major news network typically very anti-drug, discredits Ricuarte's study in their report. I will not change that immediately, however, as there is evidence (however faulty) behind it. If you have legitimate points to keep that, please respond soon. Sas556 (talk) 05:27, 17 February 2010 (UTC)

George A. Ricaurte is not a reliable source on this subject. I would suggest working on the main article, Effects_of_MDMA_on_the_human_body#Long-term_adverse_effects (which is in need of more references), and keeping the section here as a summary of that.--Pontificalibus (talk) 15:14, 18 February 2010 (UTC)

Hello. Here we have a very recent article showing the lack of neurotoxicity in humans: http://onlinelibrary.wiley.com/doi/10.1111/j.1360-0443.2010.03252.x/abstract Thanks, --79.150.179.227 (talk) 21:59, 12 December 2010 (UTC)

Prevalence

There is currently almost no information in the article about prevalence of use. I think that a section on this should be added. For example, information about the percentage of U.S. teenage students who have used ecstasy is available at http://www.drugabuse.gov/infofacts/HSYouthtrends.html. MathEconMajor (talk) 13:04, 2 April 2010 (UTC)

Solid review of the animal and human data regarding potential neurotoxicity and anxiety following MDMA administration or use

I think that the following review article (book chapter) presents a good summary of the animal and human literature concerning the potential development of neurotoxicity and anxiety following MDMA administration or use:

http://www.maps.org/w3pb/new/2007/2007_Guillot_22962_1.pdf

68.54.107.114 (talk) 18:57, 29 April 2010 (UTC)MDMAreferenceobserver

that article seems to not be peer-reviewed (it is from a book), which should be a red flag. --Butterworth99 (talk) 01:01, 11 January 2011 (UTC)

Legality in Canada

Currently, the drugbox says it's Schedule III, which is correct, but the link goes to Schedule II. The confusion here may stem from the fact that the Canadian Parliament currently has a bill to move MDMA from schedule III to II. Anyone know how to fix the link? For some reason I don't get how it works. AC (talk) 18:06, 11 May 2010 (UTC)

This was a problem in the drugbox template, which I have corrected - just waiting for the update to take effect, as soon as an admin updates the template. ῤerspeκὖlὖm ^{in ænigmate ( talk )} 23:57, 30 May 2010 (UTC)

UK Misuse of Drugs Act of 1971

"Due to the wording of the United Kingdom's existing Misuse of Drugs Act of 1971, MDMA was automatically classified in the UK as a Class A drug in 1977."

What wording? I didn't find any info on this on the article for that act. In fact, I didn't find anything about automatic classification of drugs in that article. According to the article, the drug must be listed and classified before it is illegal. What am I missing here? 98.207.159.144 (talk) 22:04, 31 May 2010 (UTC)

It's regarded as a derivative of amphetamine, so automatically went into Class A. Nick Cooper (talk) 12:29, 1 June 2010 (UTC)

Hang on, if that was the case, it would have been classified when the original act came into force. There must have been an ammendment effected in 1977 with the intention to classify it. --Pontificalibus (talk) 13:36, 1 June 2010 (UTC)

Indeed I found it was classified in 1977 by the Misuse of Drugs Act 1971 (Modification) Order 1977.(1) I therefore removed the above sentence from the section.--Pontificalibus (talk) 14:17, 1 June 2010 (UTC)

The important distinction is that MDMA wasn't classified specifically, but rather it falls within the blanket ban on derivatives of tryptamine and phenethylamine adopted in the 1977 modification to the 1971 Act. The debate in the House of Lords, for example, does name some specific drugs, but not MDMA. In fact, I think I'm right in saying that MDMA was unknown in the UK at the time. Nick Cooper (talk) 14:45, 1 June 2010 (UTC)

I reworded the UK legality section to reflect the above. --Pontificalibus (talk) 17:00, 2 June 2010 (UTC)

Edit request from Poyandow, 30 June 2010

{{editsemiprotected}} Since 1995, Multidisciplinary Association for Psychedelic Studies (MAPS)has been working to develop psychedelics into legal prescription drugs. MAPS helps scientists design, fund, and obtain regulatory approval for studies of the safety and effectiveness of a number of currently illegal substances. MAPS works closely with government regulatory authorities worldwide such as the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMEA) to ensure that all of its sponsored research protocols conform to ethical and procedural guidelines for clinical drug research. Included in MAPS’ research efforts are MDMA (Ecstasy) for the treatment of posttraumatic stress disorder (PTSD). Achievements

• Opened an FDA Drug Master File for MDMA. This is required before any drug can be researched in FDA-approved human studies.
• Assisted Dr. Charles Grob to design, obtain approval for and fund the first FDA-approved study in the U.S. to administer MDMA to humans.
• Assisted in the design and is funding the world's first government-approved scientific study of the therapeutic use of MDMA (Spain).
• Sponsored studies to analyze the purity and potency of street samples of "Ecstasy".

rrently, MAPS has been given a Schedule I license to conduct research with MDMA on veterans and survivors of physical or sexual assault who are suffering from post traumatic stress disorder, as well as with advanced-stage cancer patients who are experiencing anxiety associated with this diagnosis, the first licenses the DEA has granted for MDMA psychotherapy research.

Poyandow (talk) 02:21, 30 June 2010 (UTC)poyandow

Question: Do you have a link to where this study has been written about in an academic journal, a science magazine, or some other independent reliable source? —C.Fred (talk) 02:38, 30 June 2010 (UTC)

Not done for now: All the links provided are primary sources (the DMF filing, maps.org); there's no evidence of independent coverage in reliable sources. —C.Fred (talk) 03:25, 30 June 2010 (UTC)

The sources are not a problem (try Google News archives for 'maps mdma'), but we already mention this in the Therapeutic use section. The above text appears to be mroe about MAPS, and could be added to the Multidisciplinary Association for Psychedelic Studies article, although that contains some similar text already.--Pontificalibus (talk) 12:34, 30 December 2010 (UTC)

I just tagged the article as dated, because [[2]] notes a major study that was published over a year ago: "In the first legally sanctioned trials in the USA in over twenty years, the safety profile of MDMA has been demonstrated, and it has been shown to be a successful adjunct to psychotherapy in the management of treatment-resistant Post-Traumatic Stress Disorder (PTSD) in victims of sexual abuse and sufferers of other conditions.[9]" --Elvey (talk) 20:15, 25 May 2012 (UTC)

This is the Mithoefer PTSD study which is already cited in the medical use section. (There have been a couple of published articles from this study, as well as conference presentations.) Note: Add new topics to the end of the talk page so they are easy to see (click "new section" at the top of the page). I'm removing the dated tag, but the discussion of clinical trials of MDMA could be improved and made more detailed. Tova Hella (talk) 11:17, 20 June 2012 (UTC)

Edit request from 90.198.134.57, 11 January 2011

{{edit semi-protected}} Please change "MDMA is legal in most countries"

to

"MDMA is illegal in most countries"

90.198.134.57 (talk) 18:42, 11 January 2011 (UTC)

 Done Vandalism reverted. DMacks (talk) 18:49, 11 January 2011 (UTC)

Effects on cognitive function

Don't know why nobody bothered to update this page with Addiction's February, 2011 study, so I'll take the liberty of doing so. --134.129.54.198 (talk) 05:45, 28 February 2011 (UTC)

Nevermind, found it cited under "Harm Assessment". Any objections if it's mentioned in the "Chronic Usage" section as well? Seems relevant. --134.129.54.198 (talk) 05:51, 28 February 2011 (UTC)

so this artical says there is no cognitive imparements. http://onlinelibrary.wiley.com/doi/10.1196/annals.1432.007/abstract;jsessionid=671FB773DC5A0DC17D8D6ACEB864BD46.d03t03 and this artical says a MDMA users brain looks similar to someone who is developing alzeimers but it actually doesn't. http://onlinelibrary.wiley.com/doi/10.1196/annals.1432.007/abstract;jsessionid=671FB773DC5A0DC17D8D6ACEB864BD46.d03t03 — Preceding unsigned comment added by 71.167.63.220 (talk) 22:16, 6 July 2011 (UTC)

Animated Space-fill

I don't think the animated space-fill GIF is adding anything to the representation, and I find (unwanted) moving objects on screen annoying. Can we replace it with a static image? Jon C (talk) 04:00, 6 July 2011 (UTC)

Jakarta picture

In light of Cantaloupe2 's recent edit, I have restored the correct picture of the Jakarta factor that was erroneously changed without explanation by Editor182 on 29 November 2010. Nick Cooper (talk) 16:22, 16 August 2011 (UTC)

No 'Right Usage' Section

Do you people understand that this article has been written from the criminal point of view and is totally void of medical, that is professional usage, the right dosage etc? As criminal, it is sensationalist. Teemu Ruskeepää (talk) 14:04, 31 October 2011 (UTC)

I don't see what you're seeing, perhaps you could give some details here, or alternatively be WP:BOLD. As far as medical dosage, well there isn't one since it isn't approved by any organization that I know of for medical use. N^oformation ^Talk 18:53, 31 October 2011 (UTC)

MDMA or Ecstasy - WP:COMMONNAME?

I would have thought "ecstasy" was a more common name for this compound than MDMA. Anyone agree? NickCT (talk) 21:27, 17 January 2012 (UTC)

This has been discussed in the past; see [3]. Also WP:DRUGGUIDE. Simishag (talk) 22:04, 17 January 2012 (UTC)

Thanks for the cite to policy. I'm a little surprised by the rINN naming convention. It strikes me as though there would be examples of where WP:COMMONNAME and rINN pointed to distinctly different titles. But perhaps that a discussion for elsewhere. NickCT (talk) 16:44, 19 January 2012 (UTC)

It's a bit of a judgment call, but I think the biggest reason is that "ecstasy" was in use in the English language long before MDMA was first synthesized; see the disambig page for ecstasy. Contrast with heroin which had no previous use (and was in fact a trade name when it was legal). This page was at one point named "Methylenedioxymethamphetamine" but MDMA is certainly easier for people to type. Some have argued that "MDMA" refers unambiguously to the chemical while "ecstasy" could refer to pills sold as MDMA but really containing other substances, but this seems to me a weak argument; no one makes this argument about cocaine even though it is almost always adulterated. Simishag (talk) 17:55, 19 January 2012 (UTC)

Hmmmm... Interesting points. Out of curiosity, what is the rINN for cocaine and heroin, and what is the best source to get that info. NickCT (talk) 19:50, 19 January 2012 (UTC)

A quick search turned up this useful UN reference: http://www.unodc.org/documents/scientific/MLD-06-58676_Vol_1_ebook.pdf . The relevant answers are "cocaine", "heroin" and "3,4-methylenedioxymetamfetamine (MDMA)". Simishag (talk) 00:01, 20 January 2012 (UTC)

What do you guys think of having an ecstasy sub heading as I proposed here. Let me know if you think it's worth me making a mock-up. Gul e (talk) 19:38, 29 June 2012 (UTC)

Flagging for POV

This article is flagrantly biased towards the opinion that MDMA is not addictive. It's bizarre since it's an amphetamine, but I'd suggest you at least provide something more than two citations to support over 30 statements regarding the addictive nature of MDMA.

The chart labeled "Comparison of physical harm and dependence regarding various drugs." references citation number 58. http://web.cgu.edu/faculty/gabler/drug_toxicity.htm

It arranges the information there counterfactually by assuming that Moderate/low, Moderate, Moderate/high fall within a continuity of succession.

The chart labeled "Relative physical harm and dependence of ecstasy" combines the information from this source with the data in source 59. http://dx.doi.org/10.1016%2FS0140-6736%2807%2960464-4

These charts are presented without any context or characterization of their meaning within the main body. In fact, instead of characterizing dependency and addiction through prose, it begins: "The UK study placed great weight on the risk for acute physical harm, the propensity for physical and psychological dependency on the drug, and the negative familial and societal impacts of the drug..." but then devotes the entire paragraph to a discussion of how MDMA injuries are reported more often than paracetamol deaths.

This article presents a wealth of information indicating that few deaths occur from MDMA use yet treats psychological dependency in a facile manner.

The subarticle "Ecstasy and it's effects" has already been flagged.

My main disagreement is that this article presents MDMA as being non-addictive. It fails to mention any uniform definition of addiction physiological/psychological (cocaine and crystal meth under this criteria are non-addictive as well as they do not cause physical dependence, however it would be laughable if an article on cocaine did not mention addiction), and the article presents a bias towards the POV that MDMA is non-addictive by purposefully omitting any reference to this controversy.

I will be going through and noting all places where citation is needed. Please, do not revert them again. — Preceding unsigned comment added by Mikeyfaces (talk • contribs) 19:12, 5 February 2012 (UTC)

Are you an expert in the field? Will you be presenting any references from those who are? --John (talk) 19:20, 5 February 2012 (UTC)

I am not an expert. However, it's hard to ignore the mounds of evidence for both physical and psychological MDMA dependence.

Here is an article from 2010 Is Ecstasy A Drug of (Physical) Dependence? Abstract: http://www.ncbi.nlm.nih.gov/pubmed/19836170 Full: http://www.qcmhr.uq.edu.au/Publications/Global%20Burden%20of%20Disease/GBD%20website_2011_attachments/Degenhart%202010%20Is%20ecstasy%20a%20drug%20of%20dependence.pdf

"Few studies have examined ‘dependence’ among ecstasy users [...] An early study found that 64% of a sample of 185 regular ecstasy users met criteria for lifetime ecstasy dependence..."

"The United Kingdom survey of 1106 ecstasy-consuming dance magazine readers screened 17% positively for lifetime ecstasy dependence..."

Here are some more article and pull-quotes:

A study of 26 US university students who used ecstasy found that 14 met criteria for ecstasy DSM-IV abuse or dependence (Hanson and Luciana, 2004).

Seventeen percent of 154 Washington rave attendees screened positive on the Center for Substance Abuse Research Arrestee Drug Screener for probable ecstasy dependence; gender, race and other drug use were the strongest predictors of ecstasy dependence (Yacoubian Jr et al., 2004).

This article is simply a warehouse of all previous studies concerning ecstasy dependence.

The part of the article marked 4. Summary and implications is a good idea of what I feel we need to include.

I'd also appreciate it if JOHN would stop removing the POV flag before this issue is resolved. — Preceding unsigned comment added by Mikeyfaces (talk • contribs) 20:00, 5 February 2012 (UTC)

It is quite difficult to take you seriously when you misrepresent sources, as you have done twice now. I'll let the tag stay for 24 hours or so to see if there is any real issue; so far from your edits I do not see one. --John (talk) 21:11, 5 February 2012 (UTC)

• I note that the source you cite in support of MDMA's physical addictiveness contains this: "Some people report problems controlling and concern about their use, but the notable lack of case reports of severe withdrawal syndromes in the literature suggests that physical symptoms play a more limited role than psychological ones. Although tolerance has been reported, as has withdrawal, the relevant literature consists largely of self-reports in research studies involving questionnaires designed for the assessment of withdrawal from other drugs. Animal models similarly suggest that any withdrawal syndrome is much less severe than for other drugs of dependence." --John (talk) 23:12, 5 February 2012 (UTC)

I'm going to assume the issue is now resolved. I am taking down the tag now. --John (talk) 22:41, 6 February 2012 (UTC)

ecstasy pills may be far different from MDMA

i think there should be an article about them Nikos 1993 (talk) 16:51, 13 February 2012 (UTC)

are you saying there should be a separate article about non-MDMA "ecstasy" pills? --Thoric (talk) 23:52, 16 February 2012 (UTC)

i think MDMA and Ecstasy (drug) should be splitted as they were before. Nikos 1993 (talk) 18:26, 17 February 2012 (UTC)

• I disagree, I think they are fine at the long-standing consensus positions. --John (talk) 11:28, 19 February 2012 (UTC)

While I do not think there should be two separate articles ('MDMA' and 'Ecstasy (drug)'), this article should definitely make it clear that 'ecstasy tablets', 'bickies' or 'pills' do not necessarily contain MDMA or may contain MDMA in conjunction with other chemicals and drugs in unpredictable proportions. It is important to highlight this fact so that people can accurately interpret any discussion of health risks or research - for example, compound ecstasy pills (the norm) are likely to have unpredictable health risks, while the risks associated with pure MDMA powder/rock are more readily discernable. Ecstasy pills may contain heroin, amphetamines, ketamine, LSD and a whole host of other drugs in addition to, or instead of, MDMA, as well as household cleaning products such as ammonia or bleach, talc powder, etc etc. Obviously any discussion of 'ecstasy pills' needs to be distinguished from MDMA for the purposes of clarity, even if ecstasy is commonly interpreted as MDMA based because of its history. [Jess] -- — Preceding unsigned comment added by 118.209.39.133 (talk) 05:04, 6 April 2012 (UTC)

Purity is already addressed in this article. Furthermore, there are no separate articles for "cocaine" and "blow", or "heroin" and "junk". In a drug context, "Ecstasy" means "MDMA". I am aware of no sources that suggest otherwise. Adulteration is a common problem with the purchase of illicit substances, and I don't mind mentioning that within this article, but creating a separate, inherently speculative article to discuss a fairly small aspect of MDMA is just silly. Simishag (talk) 18:54, 6 April 2012 (UTC)

Thanks for your response Simishag - I can see you've already discussed this with others elsewhere too, which must get a bit tiring for you, so apologies for dragging it up again. Nonetheless, I would suggest that there is a significant difference between the heroine/junk or cocaine/blow versus mdma/ecstasy distinctions. My understanding is that when people talk about junk, they are always referring to heroine, and when they talk about blow they always mean cocaine - regardless of how clean the substance is - whereas when people talk about ecstasy they may or may not be talking about MDMA-based pills - it's essentially the 'pills' that they are referring to rather than the drug, even if the original 'pills' were primarily vehicles for MDMA. If those same people who were talking about 'ecstasy' were discussing MDMA in powder, rock or capsule form, on the other hand, they wouldn't use the term 'ecstasy', they would use the term 'MDMA'. At least that is the case in Australia. The article already does an excellent job of pointing this out in the purity section - if that is your work then well done :-). The reason I stress this is primarily because what research and reports exist relating to death and/or neurotoxicity and/or dangers may be mistakenly interpreted by some as referring to 'ecstasy pills' when in fact they refer to the chemical MDMA, or vice versa. Anyway - keep up the good work, Jess-- — Preceding unsigned comment added by 118.209.39.133 (talk) 12:40, 9 April 2012 (UTC)

Date rape

I moved the recently added paragraph on date rape from the intro to the adverse effect section. MDMA is not considered a date rape drug (although of course there are cases of people being raped while on MDMA), so I don't think this belongs in the introduction. The book cited, Designer Drugs by Olive and Triggle, is written for teenagers, so a better source is needed. I'm not really sure where to mention date rape or what, if anything, to say about it. Tova Hella (talk) 21:47, 1 March 2012 (UTC)

Environmental concerns

The section describe the environmental effects caused by the harvesting of safrole, a substance used to manufacture MDMA. As this section fails to describe the effects of the harvesting, nor how big impact MDMA have, do I not see why the section is notable. A near copy of this section is already in safrole's article, so I petition for its removal from this article. — Preceding unsigned comment added by 83.109.118.189 (talk) 21:49, 18 June 2012 (UTC)

I came here to propose the same; if MDMA production consumes a negligible part of world safrole production, this should at most come as a mention in a discussion of precursors. Rodface (talk) 18:52, 14 September 2012 (UTC)

EU trends in MDxx sales and piperazines

Most of the information in this section should be on a separate page. Details about drugs other than MDMA should be on pages for those drugs. There has been a lot of debate about having an "ecstasy pill" page. That is probably a good idea for this sort of information. Tova Hella (talk) 11:42, 20 June 2012 (UTC)

Stereoisomers & the Skeletal formula

Though I'm not a chemist, it is my understanding that there are two stereoisomers of MDMA, much like amphetamine, methamphetamine etc. (see here. If the same trend is true as with these similar drugs they will likely have different effects. In fact I have read that they do. It seems like it's worth mentioning in the article. Maybe I'll try and include it at one point but if someone more experienced would like to step in....

Or in fact the reason I started this is that the skeletal formula does not illustrate the presence stereoisomers for the molecule. If my understanding of this is correct a wavy line, as shown in the alpha methyl bond on the amphetamine and methamphetamine skeletal formulae indicate the stereoisomerism. Therefore the MDMA skeletal formula svg should also have a wavy line as the alpha methyl bond. Is that correct? If so, who works with svg files and can change it? Gul e (talk) 20:05, 29 June 2012 (UTC)

Subjective

Only the good effects are Subjective?

and the bad ones aren´t? 89.153.211.135 (talk) 01:15, 30 June 2012 (UTC)

US Prices

“ The United Nations Office on Drugs and Crime claimed in its 2008 World Drug Report that typical U.S. retail prices are lower, costing 20 to 25 per tablet, or from 3 to 10 per tablet if bought in batches. ”

Is this supposed to be in US$? I guess it is, but I'm really not sure, so I am reluctant to be WP:BOLD. Nevertheless, it needs SOME kind of unit. -DrGaellon (talk | contribs) 19:42, 14 September 2012 (UTC)

Nomenclature

Should it not be (RS)-1-(benzo[1,2-d]dioxol-4-yl)-N-methylpropan-2-amine? My logic is that the dioxolane fuses its d side most simply with the 1,2 position on the benzene, which then branches out at the 4 position.

I have only recently learned nomenclature of fused ring systems, so I may be wrong.

Reference: (pdf) Page 26

Starprizm (talk) 06:09, 25 November 2012 (UTC)

Overdose

I've recently added several references to the overdose section. This section still contains many unreferenced statements, which I cannot find a citation for. Considering there has been a citation request for that section for over 3 years now, I'm guessing nobody else can find one for them either. I propose removing the unreferenced statements and the associated tag. There will still be 20 referenced symptoms once all the unreferenced ones are removed. This is just a friendly warning in case anyone else wants to do some last minute reference searching. Freikorp (talk) 11:29, 13 December 2012 (UTC)

Done. Freikorp (talk) 03:31, 16 December 2012 (UTC)

That's a pretty unscientific reference supporting the inclusion of death as a possible overdose result. I'd like to see the inclusion of something more scientific and research based. Of course, that will be rather hard to provide since there isn't any such evidence. MDMA can lead to heat stroke, which if untreated (you know, drink some water) can lead to death. That's not death by MDMA, that's death by dehydration and stupidity. Here is a nice article, based on scientific research published in a scholarly medical journal, supporting this. Obviously, it is still unequivocally detrimental to one's health, but directly resulting in death? That's a stretch. http://www.theguardian.com/society/2006/apr/04/drugsandalcohol.drugs1Brakoholic (talk) 18:48, 28 September 2013 (UTC)

I totally agree. "Nancy Caroline's Emergency Care In The Streets" is not a credible source. I suggest that 'death' be removed from the list of side effects until there is a definitive, credible, scientific source that says it is. Chalky (talk) 23:02, 4 January 2014 (UTC)

Changing the title of the article

Since this article discusses MDMA within several contexts, not all of which are scientific, I really think it would be proper to include the street name of this drug in the article heading. — Preceding unsigned comment added by 50.1.84.230 (talk) 01:21, 8 January 2013 (UTC)

The street names are mentioned in the first paragraph. All of XTC (disambiguation), X (disambiguation), and Ecstacy include links to this article. 24.98.1.233 (talk) 21:00, 12 January 2013 (UTC)

Mandy

The article currently states that "Mandy" is a slang term for MDMA in the UK. There is a citation, but this is weak. I'm 57 and far removed from the dance scene, but I've never heard this term used to refer to MDMA. It is an old British slang term for Mandrax though this drug largely went out of use in the 1970s. This usage is referenced in the Ian Dury song Hit Me With Your Rhythm Stick, released in 1978 when recreational MDMA use was largely unknown. --Ef80 (talk) 00:59, 14 January 2013 (UTC)

As the page notes, it is a common term for the crystalline form of the drug, and is an obvious play on the sound of "MDMA" (e.g. [4]). That the same word was previously used for Mandrax is completely coincidental. Nick Cooper (talk) 17:59, 14 January 2013 (UTC)

Where has the comprehensive desired effects list gone?

There was a rather comprehensive list of desired 'subjective' effects on here last I looked; now it has vanished. It seemed very accurate but now it has gone. Has it been forced out or just removed by some fearful personage? — Preceding unsigned comment added by 77.102.119.108 (talk) 12:04, 6 March 2013 (UTC)

Structure

The benzodioxole termination of mdma is shared with piribedil and even paroxetine; may be the benzodioxole a ligand to D2 receptor for an agonist action?

79.41.235.169 (talk)

Structural formula

How are these two chemical structures related? The first one is used as the main image of the article, but the second one is used throughout the article. Are they chemically equivalent? I am a chemistry newbie, but they certainly look different to me. --Farzaneh (talk) 21:29, 26 June 2013 (UTC)

• 
  The main image in the article
• 
  Structure used throughout the article

In organic chemistry the hydrogens are usually not represented while the carbons are represented by an angle. 79.41.235.169 (talk) 15:35, 30 June 2013 (UTC)

79.20.9.3 (talk) 21:54, 30 June 2013 (UTC)

United States section

Would someone please look at the first sentence of the second paragraph? I would like to make sense of it but fall short. "In 2001, responding to a mandate from the U.S. Congress, the U.S. Sentencing Commission, resulted in an increase in the penalties for MDMA by nearly 3,000%.". Apparently the U.S. Sentencing Commission did something (met, changed a law, etc..) that resulted in the penalty increase. For some reason, "In 2001, the U.S. Sentencing Commission, in response to a mandate from the U.S. Congress", ....did something. Otr500 (talk) 20:22, 29 August 2013 (UTC)

Nonsensical paragraph

I removed the paragraph below per the above comments. I do not have access to the references to make sensible corrections so if someone does they can make the corrections and add it back.

• In 2001, responding to a mandate from the U.S. Congress, the U.S. Sentencing Commission, resulted in an increase in the penalties for MDMA by nearly 3,000%. The increase in penalties was opposed by the Federation of American Scientists.The increase makes 1 gram of MDMA (four pills at 250 mg per pill's total weight regardless of purity, standard for Federal charges) equivalent to 1 gram of heroin (approximately fifty doses) or 2.2 pounds (1.00 kg) of cannabis for sentencing purposes at the federal level. See also the RAVE Act of 2003. Otr500 (talk) 01:47, 28 September 2013 (UTC)

Safrole: Essential or not?

Two quotations from the current version:

"Safrole, a colorless or slightly yellow oily liquid, extracted from the root-bark or the fruit of the sassafras tree is the primary precursor for all manufacture of MDMA."

"Safrole is not required for MDMA production, and other precursor chemicals are often used instead, for example piperonal."

This is confusing. Does it mean safrole is the precursor for all MDMA because synthesis may start with other precursors, such as piperonal, which is derived from safrole? Is the second sentence confusing, or the first one in error? Mazoola (talk) 08:18, 23 September 2013 (UTC)

This does seem confusing. Safrole is the preferred precursor, so I guess that would make it the "primary" precursor, but it is not the only possible precursor. Piperonal can be extracted from several plant sources, and you could synthesize it from safrole, but if you were making MDMA starting with safrole, you would not convert it into piperonal. --Thoric (talk) 21:28, 25 September 2013 (UTC)

Recreation Section

This part reads more like an advertisement than an explanation, especially the part concerning the desired effects. "Sense of Inner Peace?" — Preceding unsigned comment added by 199.180.217.169 (talk) 17:52, 2 March 2015 (UTC)

It is supported by a MEDRS compliant source which uses that phrasing. I don't see any problem with it. Sizeofint (talk) 18:30, 2 March 2015 (UTC)

That being said, the entire section needs expansion. I or someone else will likely be improving it in the coming weeks/months. Sizeofint (talk) 18:33, 2 March 2015 (UTC)

Controversy: Harm assessment section

The article claims "They did not evaluate or rate the negative impact of 'ecstasy' on the cognitive health of ecstasy users, e.g., impaired memory and concentration." however, its reference is to a BBC news story which makes no such claims and refers to the Lancet article "Drug harms in the UK: a multicriteria decision analysis" which has clearly stated in its methodology that long term harms physical and psychological were taken into account.

I quote from the criterion list of that article: "Drug-specific impairment of mental functioning: e.g. amfetamine-induced psychosis, ketamine intoxication Drug-related impairment of mental functioning: e.g. mood disorders secondary to drug-user’s lifestyle or drug use"

Thus, this claim doesn't merely cite an article of evidence which doesn't back their claims, it cites one which refutes them. This MUST be rectified. CEY-19 (talk) 12:02, 1 February 2015 (UTC)

The information in that section is actually from a 2007 study. However, I've added the conclusions from the 2010 study into the section. Sizeofint (talk) 20:00, 1 February 2015 (UTC)

Serious review of entire page is required

The facts are simple, this entire page on MDMA needs to be reviewed. The recreational affects, potential therpetuic effects ie PTSD, true mechanism of action or potential mechanism of actions need to be updated. MDMA has a wide pharmacocology.

This page makes it seem worse than heroin.

Someone who is educated, get started now. — Preceding unsigned comment added by 175.38.198.193 (talk) 04:35, 27 December 2014 (UTC)

Normal dose

There is no mention of normal dose. If someone is caught with 50 grams of extasy is it a lot? How many dose can one make from pure 1 gram of MDMA?--RicHard-59 (talk) 21:45, 27 May 2014 (UTC)

Channel 4's Drugs Live programme in 2012 used single doses of 83mg in the experiment, which would be almost exactly a twelfth of a gramme, and broadly in line with the average active content in street pills at the time and previously. In the UK someone caught with 50 grammes (i.e. approximately 600 doses, with a street value of at least £2,000) would almost certainly be charged with possession with intent to supply (others), as opposed to simple possession for personal use. Nick Cooper (talk) 12:45, 28 May 2014 (UTC)

Shulgin's notes [5] suggest a dosage of 80-150mg (his experiments range from 60-200mg). I have frequently heard 100mg, which is in agreement and is also a nice round number: 1 gram = 10 doses. Pills typically have a mass around 100mg, but purity varies widely so it's difficult to equate pills to doses. The legal definition of a dose, if used in a criminal prosecution, might be something else entirely but it should be defined in statute or regulation. Simishag (talk) 19:44, 28 May 2014 (UTC)

I suspect the 83mg has its origin in it presumably being easier to separate a supposed gramme of powder into twelve "by eye," than it is to divide it into ten. Nick Cooper (talk) 13:06, 29 May 2014 (UTC)

I question the source for "In the early 1980s clubbers started using MDMA in Ibiza’s discos.[146]"

The source for this statement is a blog post with no references. http://artsbeat.blogs.nytimes.com/2013/09/12/overdoses-of-molly-led-to-electric-zoo-deaths/?_r=0

I personally question the veracity of the statement as well as the appropriateness of using a blog post as the basis of fact in a wikipedia entry. 66.64.59.58 (talk) 16:54, 24 June 2014 (UTC)

Pretty much every account of dance culture and MDMA use in the UK notes that in Europe it surfaced in Ibiza first (e.g. Saunders, C0llin, and Garratt). Even so, there is a difference between a regular blog, and a New York Times blog. Nick Cooper (talk) 22:27, 24 June 2014 (UTC)

I agree with User:Nick Cooper on this. Tova Hella (talk) 17:57, 1 November 2014 (UTC)

Sciency chatter

The following is meaningless, scientific-sounding gabble, and ought to be removed:

"The positive effects were so large as to achieve statistical significance in spite of the small size of the trials (In one study, the rate of clinical response was 10/12 (83%) in the active treatment group versus 2/8 (25%) in the placebo group. In the other study, a p-score of 1.4% was found for the PDS scale and 1.6% for the CAP scale one year after treatment. A p-score of 5% or less is often considered statistically significant, and the effect found needs to be larger with smaller studies to have statistical significance, ceteris paribus, in order to correct for sample size.) In the second study, positive effect in CAP scale immediately after treatment did not achieve statistical significance (p=6.6%), but may do so with a larger sample size. The patients treated with two or three sessions of MDMA-psychotherapy showed greater improvement than the ones treated by placebo-psychotherapy or placebo-inactive dose of MDMA.[18] This improvement was generally maintained on a follow-up several years later." Dratman (talk) 13:43, 4 August 2014 (UTC)

Going to butcher several sections of this article...

Like the title says, I'm going to cut out a lot of the medical content which fails WP:MEDRS and rewrite/resource a few parts. The health effects of MDMA article is redundant with what the article is supposed to include per WP:MEDMOS, so I'm going to merge that article into this one after cutting out its inadequately sourced content. I expect I'll get around to it sometime over the next month or so. Seppi333 (Insert 2¢ | Maintained) 06:22, 22 August 2014 (UTC)

Others to add:

• http://dx.doi.org/10.1080/02791072.2014.873690
• http://dx.doi.org/10.1002/hup.2390
• http://dx.doi.org/10.1002/jcph.266
• http://dx.doi.org/10.7748/en2014.02.21.9.32.e1128
• http://dx.doi.org/10.1016/j.lfs.2013.07.014

Adverse + OD

PDynamics

• VMAT2
• TAAR1

PKinetics+Toxicity

Seppi333 (Insert 2¢ | Maintained)

References

Please do me a favor and bring something up on the talkpage - either in this thread or a new one - before reverting a change I make. More than likely I intend to rewrite/resource a section if I completely delete one. Content that I remove is usually indicated for a particular reason in an edit summary.

This also isn't the first time I've rapidly rewritten a high-traffic article: e.g., methamphetamine (now a GA) and nootropic. Seppi333 (Insert 2¢ | Maintained) 14:16, 16 October 2014 (UTC)

Thanks for your work on this article (and on previous ones)! DMacks (talk) 14:41, 16 October 2014 (UTC)

Thanks Seppi333 (Insert 2¢ | Maintained) 20:36, 16 October 2014 (UTC)

"Butchering" is the right word, especially as regards the "Legal status" section and particularly the "United Kingdom" subsection. I would note that in the process you deleted everything about the ACMD's recommendations on the reclassification of MDMA (discounting them as "court battles and random controversy"), which seems convenient to the agenda you're apparently pushing. Nick Cooper (talk) 09:22, 17 October 2014 (UTC)

I have virtually no interest in this article topic. If it didn't have abhorrently shitty sources, I wouldn't be editing it. I'm only doing this since I already have a lot of familiarity with MDMA from significantly revising/expanding articles on its pharmacology and on other substituted amphetamines.

A drug legal status section is simply supposed to quickly summarize the global legal status as a controlled substance, with selected countries where editors have supplied supporting citations. It's not a place to cover current perspectives on the legality of drugs. That material would go into a history/society/culture section, and I'm not opposed to covering that material there (without massive blockquotes in the text); that said, I haven't decided whether or not to merge this page's section with history and culture of substituted amphetamines yet though. Seppi333 (Insert 2¢ | Maintained) 10:36, 17 October 2014 (UTC)

Agree with Seppi that the Legal section was largely a long winded argument that MDMA is over-regulated and was way out of touch with WP:NPOV. The article overall was riddled with advocacy and the use of non-reliable sources (Dancesafe.org???, Ectascydata.org???, theDEA.org??? Seriously?). I think there is room for discussion of specific changes, but the overall need for a cleanup is beyond question.

Seppi has a great track record as an editor of CNS drug related articles and I'm pleased to see him taking this task on. Formerly 98 (talk) 12:39, 17 October 2014 (UTC)

On what grounds are those sites "non-reliable" in the context that they were originally cited? Or do you take the view that any site that does not take a prohibitionist stance is inherently unreliable? Whether you like it or not, the legal status of MDMA is questioned in a number of countries, not least by the UK government's advisory body. We should refelect such debate, not pander to a line of "Drugs are bad, m'kay?" Nick Cooper (talk) 12:52, 17 October 2014 (UTC)

WP:MEDRS - the answer to your first two questions - is why it's not ok to cite "Bob's I love ecstasy blog" as a reference for medical information on MDMA. I'm not even remotely interested in its legal status and don't even want to edit content on that - I'm not here to write a DARE pamphlet, just an accurate description of the drug effects and the current evidence of its therapeutic potential. MDMA is neurotoxic, so it borks your brain over the long term; the article will reflect that. MDMA is also a euphoriant, so it makes you feel really good - the article will reflect that too. Seppi333 (Insert 2¢ | Maintained) 13:41, 17 October 2014 (UTC)

Take a look at WP:MEDRS. Secondary sources published in peer reviewed medical journals or medical textbooks are required for health related content. And advocacy sites and blogs fail even the lower standard of WP:RS Formerly 98 (talk) 13:32, 17 October 2014 (UTC)

I'd also suggest taking a look at WP:NPOV and WP:UNDUE. The central concept is that Wikipedia describes controversies, it does not take sides in them. The POVs of each side are given space in proportion to their predominance among experts. Selectively hunting down and quoting documents suggesting that MDMA is over-regulated violates both of these. And no, its not "Mmm, drugs are bad, ok?' I would be equally opposed to an overdrawn discussion endlessly restating the risks of these drugs and selectively quoting those who feel that greater enforcement activity is warranted. We're not here to write editorials. M'kay? 2605:E000:1C0C:80F7:1DD5:6CD2:EB00:6646 (talk) 14:01, 17 October 2014 (UTC)apologies, forgot to login Formerly 98 (talk) 14:49, 17 October 2014 (UTC)

So you're making a value judgement that other editors have been "Selectively hunting down and quoting documents suggesting that MDMA is over-regulated"? Like the ACMD report, you mean? Nick Cooper (talk) 15:20, 17 October 2014 (UTC)

So which sites are your characterising as "Bob's I love ecstasy blog" and why? You claim that you are "not even remotely interested in its legal status and don't even want to edit content on that" when that's precisely what you have done. The scope of this page has long been far wider than, "an accurate description of the drug effects and the current evidence of its therapeutic potential," but you've arbitrary decided to narrow the focus. Nick Cooper (talk) 15:20, 17 October 2014 (UTC)

For all intents and purposes, I'm characterizing all of the above, and anything which is not recently published by a governmental drug agency/entity, a credible professional medical entity, or an academic authority in pharmacology, as "Bob's I love ecstasy blog." Why? Because all those things (i.e., the vast majority of possible things you could cite) fail WP:MEDRS, which is an extremely strict standard. Edit: you misunderstand my meaning; my only objective in this article is to bring that part of this article (drug effects and therapeutic potential) up-to-date. I'm not going to work on the rest other than to fix grammar/flow issues, make appearance tweaks, and possibly add citations to the non-medical sections. Seppi333 (Insert 2¢ | Maintained) 15:37, 17 October 2014 (UTC)

...forgot to add: and delete massive blockquotes. Seppi333 (Insert 2¢ | Maintained) 15:58, 17 October 2014 (UTC)

Sounds to me that both you and Formerly 98 have got a load of ready made excuses for deleting whatever you don't like, and are doing it in a manner that makes it virtually impossible for any other editor to proper scrutinise your edits.

You're still ignoring the question as to why you eviscerated the "Legal status" section while claiming to be "not even remotely interested in its legal status and don't even want to edit content on that." Nick Cooper (talk) 08:40, 18 October 2014 (UTC)

Read the highlighted text.

If you feel we're overzealously enforcing WP:MEDRS by removing sources in the article, you can seek a second opinion from other medical project editors if you like. There's currently a section on this article on the project talkpage if you want to reply under it: WT:MED#3,4-Methylenedioxymethamphetamine merge. Seppi333 (Insert 2¢ | Maintained) 12:47, 18 October 2014 (UTC)

By the time I'm done sourcing and copyediting the article, it won't look much different than its current revision. I don't intend to change the layout or delete content from any additional sections, except in pharmacokinetics, at the moment; pharmacokinetics contains some trivial material - also needs medical sources. Seppi333 (Insert 2¢ | Maintained) 16:22, 18 October 2014 (UTC)

It may have escaped your notice, but this page is within the scope of a number projects, and one doesn't get to dictate that the page can only conform to its own rules. Nick Cooper (talk) 08:40, 19 October 2014 (UTC)

MEDRS is not just a policy of the Medicine Project, but of Wikipedia overall. Take a look at WP:RS Formerly 98 (talk) 11:50, 19 October 2014 (UTC)

What happened to the MDMA page??? I agree with Nick Cooper, it is unacceptable to delete large sections of an article without discussion. Seppi333 deleted large sections of the history of regulation and harm assessment of MDMA, including quotes from official reports and respected NGOs. For instance, all mention has been deleted of the 1985/86 DEA court hearing which concluded that MDMA did not fit the criteria for Schedule I. You can't just delete history. Please, Nick, could you revert these changes? Tova Hella (talk) 17:35, 1 November 2014 (UTC)

I'm going to immediately delete any blockquote that I see on this page. If you want to re-add content on a blockquote that I deleted or moved inside a ref's quote parameter, summarize it and cite the source; otherwise, you can expect my impending revert.
As I've already stated, I had/have no issue with anything else related to that blockquote content - the citation and material covered in the blockquoted text were fine for inclusion on this page, but the coverage of that material using a massive blockquote is not fine. That said, placing blockquoted text in a citation's quote parameter is both an acceptable and useful way of quoting a large amount of text; I did that with nearly every reference I added to this page. Seppi333 (Insert 2¢ | Maintained) 18:20, 1 November 2014 (UTC)

In the event it's not obvious, there's a WP:POV issue with expanding sections excessively by adding blockquoted text like this - it adds excessive coverage to subtopics that should not have that much WP:weight placed upon them. So, I actually can delete large amounts of text that give undue weight to a topic like that. Seppi333 (Insert 2¢ | Maintained) 18:20, 1 November 2014 (UTC)

Tova Hella It will be much more helpful if you describe specific changes that you object to rather than WP:JDL. And BTW he did describe exactly what he planned to do almost 2 months before he did it and no one voiced any objection or responded to his notice in any way during those 2 months, making the complaint about "massively editing the article without prior discussion" a little incomprehensible. The article was a nightmare of statements supported solely by sources that do not meet Wikipedia's quality standards for medical content (please see WP:MEDRS) prior to Seppi's cleanup, and I fully support what he has done. Formerly 98 (talk) 06:20, 2 November 2014 (UTC)

Set

--83.80.250.145 (talk) 19:30, 22 August 2014 (UTC) Hallo,

What I miss in most drug-related texts is the "set". By this I mean to say that it is very important who is taking the drug and under which circumstances. In some cases the effect of the drug can be detrimental and long-lasting. It is like the Jellinek Clinic in Holland in former website articles said: You are your own laboratory rabbit!

Sincerely,

J.P. Clifford

Edit request to fix red link

At the beginning of the section MDMA#Long-term effects on serotonin and dopamine, there is a red link that goes to serotonin reuptake transporter. Corresponding articles already exist at serotonin and reuptake transporter (which redirects to monoamine transporter), and it could be fixed. 50.32.195.213 (talk) 23:49, 26 August 2014 (UTC)

Done AlanS (talk) 03:00, 27 August 2014 (UTC)

term of mdma

119.93.155.200 (talk) 01:59, 3 September 2014 (UTC)

You have not specified an edit and I have therefore closed the request. - Camyoung54 ^talk 02:56, 3 September 2014 (UTC)

MDMA is not Ecstasy

First paragraph, second and third lines need to be changed...they confuse ecstasy, pure MDMA, and Molly

MDMA is a chemical.

Molly is **PURE** MDMA that is made to be used as a recreational drug.

Ecstasy is **adulterated** MDMA, usually "cut" with methamphetimines, cocaine, acid, or cheap heroin

MDMA = chemical

Molly = pure MDMA as a recreational drug

Ecstasy = adulterated MDMA — Preceding unsigned comment added by 71.222.52.34 (talk) 19:03, 5 September 2014 (UTC)

I guess I'm aging myself here, but as I knew things 15 years ago in Los Angeles, "Molly" meant MDMA powder (presumably relatively pure) and "Ecstasy" (or "E" or "X" or "XTC" or whatever) meant pressed MDMA pills (again, presumably relatively pure). Today, "Ecstasy" (et al) means just about anything, and "Molly"... well, I'm not really sure what that means. "MDMA" and/or "3,4-methylenedioxymethampehtamine" is a very distinct and clear representation. Anything else is just an uncited street name, whose meaning can vary widely by location. Still, "Ecstasy" has pretty much always implied "MDMA". Sources for/against would be welcome. Simishag (talk) 18:58, 17 October 2014 (UTC)

2.197.50.141 (talk) 20:05, 28 October 2014 (UTC)

"Research"

The "research"-paragraph is biased to the point of being blatantly wrong. The research on MDMA - and especially MDMA as an adjunct in psychotherapy - is divided into proponents and repudiators, with not much common sense in the middle ground. At the moment the paragraph pretty much relies on the papers of one scientist (A.C. Parrott) who is known as a radical prohibitionist and alarmist when it comes to psychoactive substances (while actually being clueless about psychotherapy). He has devoted much of his academic career to literally "fight ecstasy". That is not to say that his position is invalid but simply that his position is unbalanced - he simply has the position of a researcher on the adverse effects of "Ecstasy"-abuse.

The state of the research on MDMA in psychotherapy is not so dubious as the paragraph implies. This also includes the dangers associated with clinical application of MDMA. There is sufficient published high quality info on those topics to give a more balanced view on those issues. Unfortunately I have no time for working on this... :( — Preceding unsigned comment added by 2.197.50.112 (talk) 10:59, 28 October 2014 (UTC)

There's two reviews in the article that cover the therapeutic use of MDMA. The second one - PMID 24648791 - is slightly older and authored by a different individual, but takes essentially the same position. It's not cited in that section though. Seppi333 (Insert 2¢ | Maintained) 12:57, 28 October 2014 (UTC)

2.197.50.141 (talk) 20:05, 28 October 2014 (UTC) You write: "takes essentially the same position". And there's the problem ;). There are fundamental differences between abuse oriented/forensic/pathogenetic - that is: naturalistic - investigations on Ecstasy and experimental (sic!) clinical trials with MDMA (iirc H. Sumnall has written on this issue). These problems have nothing to do with ideology but control over variables and quality of data. Unfortunately a few researchers do not seem to recognize these problems. And then there is also a "pathology in -> pathology out" principle. F. Vollenweider et al. as well as D. Nutt and R. Carhart-Harris (all of them quite renowned researchers in their fields) have conducted extremely well controlled clinical studies and have not found evidence for neuronal damage - let alone functional deficits. The same goes for the few but also well controlled therapeutical studies with MDMA. Btw: The studies conducted [NOT by MAPS-staff but sponsored] by MAPS were designed and conducted as RCTs, however it is obviously not possible to 100% successfully double blind trials with strong psychoactive substances - I won't bother looking it up but the blinding-rate was still not as bad as one might think (they were definitely not "unblinded"). In the Oehen-study (the one that "failed to demonstrate a statistically significant effect" - the inclined reader may have a look at the number of subjects and effect sizes!..) an active placebo has been used to tackle that issue - a strategy that carries its own problems. Ad effect sizes: Did the author of this paragraph actually read and understand the Mithoefer studies?!

Don't get me wrong: There is no doubt that there is pre-clinical and (some) naturalistic evidence that chronical and/or high dose MDMA-abuse is detrimental to mental health and functioning. However there is also evidence that controlled application of 2-3 known doses of pure MDMA does not cause detrimental effects - not even a significant "hangover" btw [and besides healthy subjects we are also talking about extremely vulnerable treatment resistant PTSD-patients here]. (Research on) abuse of Ecstasy and clinical application of MDMA has to be treated differently for methodological reasons.

You see: I tend a little bit to the proponents-side of the spectrum... ;) Hey I could rewrite the paragraph in the same style it is written now but with unlike signs and it would sound like MDMA could be the second coming materialized in a substance... ;) -> As it is now it is just not scientific. It is actually misleading and simply wrong in some points (I refrain to say: "lies"). Summarizing the literature I could also say that it actually reflects a position that is increasingly on the fringe.

Unfortunately research in this field almost always comes with a "spin". There is always ideology involved. Maybe describing both sides would be helpful. 2.197.50.141 (talk) 20:05, 28 October 2014 (UTC)

I'm not sure what your issue with the language in that section is given your argument. Parrott argues that MDMA does have efficacy based upon the Mithoefer study; the section reflects this by stating it has limited efficacy. That study didn't examine the presence of neurotoxicity or functional impairments in memory in the study participants. In any case, this article can't make medical statements without a medical review supporting a particular claim. Seppi333 (Insert 2¢ | Maintained) 15:03, 30 October 2014 (UTC)

5.168.234.124 (talk) 19:13, 30 October 2014 (UTC)

OK; /my/ issue is, that it reflects an academic position, which I oppose. Actually it reflects the position of an author I actually refuse to cite in my own work as he, in my opinion, has a few times too often crossed the line of scientific depiction towards "moral" founded fear mongering, using the means of exaggeration and misrepresentation. (Despite doing valuable work in some cases.)

However it's not just me to make up this academic controversy, it's been going on for I think over 20 years - and much of it is published (caveat emptor this, caveat emptor that, response to this, response to that). This controversy should be reflected in the article.

/My/ second issue is that I - at the moment - have no time to cite (INCLUDING Parrott ;)) the sh** out of the topic and rewrite the paragraph towards a more balanced representation. Neither do I have time to write and publish a review during the next few days. ;)

Right now the lay reader will read the paragraph and think "some hippie organization is doing pseudo science to find a reason to do drugs. And drugs make holes in your brain." Which is a misrepresentation.

ad "limited efficacy": I wouldn't call an effect size of 1.24 in treatment resistant patients "limited efficacy".

ad "didn't examine [...] functional impairments": Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Paced Auditory Serial Addition Task (PASAT) and Rey-Osterrieth Complex Figure (RCFT)were applied with no significant differences between the 2 experimental conditions. This is in line with every other clinical RCT applying MDMA in a way that would be therapeutically useful.

Examining "the presence of neurotoxicity" in vivo is not possible (afaik!).

ad "unblinded" (as in the paragraph): the Mithoefer studies had a gold standard design. Because this is what you have to do in phase II clinical research. Blinding did not really succeed because there is no way [smart people spent a lot of time thinking about that problem] to conduct a study like that in a methodologically bullet proof fashion.

...there are no "safe medical treatments" btw. MDMA is no wonder drug and no silver bullet and it comes - like any other (psychiatric) medication/intervention - not without risks and side effects - but quite a few experts in the field came to the conclusion that the benefits outweigh the risks. Increasing evidence shows that, as an adjunct to psychotherapy, it can be applied effectively and without detectable harm to the patients. More research is indicated.(<- this is also a valid position, but some might not want to hear it because of reasons that are not to be found in the realms of science&medicine...unfortunately the field is as complex as it is biased. :/ Things would be fundamentally different if MDMA would have been developed - say - last year.)

I hope my position is clearer now. I'm bowing out.

5.168.234.124 (talk) 19:13, 30 October 2014 (UTC)

Human in vivo neuro-toxicity/plasticity studies are performed via neuroimaging, often as functional- and/or structural-MRI. Based upon the names of those tests, I gather none of them examine functional impairments in memory. I'm not entirely sure an uninformed lay-reader is going to take such a general interpretation about all psychoactive drugs from that paragraph. The only thing one can logically infer from reading this article is that MDMA is a direct neurotoxin to human 5-HT neurons and has no current approved medical uses. That fact doesn't necessarily mean it's not suitable for some form of medical use in the future - e.g., methamphetamine is a direct human DA neurotoxin, yet it's a US schedule 2 prescription drug (and its levorotatory enantiomer is actually OTC...).
Nonetheless, I suppose I'll rework the language of that section over the weekend to make this clear. Seppi333 (Insert 2¢ | Maintained) 02:31, 31 October 2014 (UTC)

217.200.150.57 (talk) 11:23, 31 October 2014 (UTC) scnr. 1. Sorry, maybe I misunderstood, but I question your competence if you honestly think the neurotoxic effects of 3 [or make it 300..] doses of MDMA can be seen via any form of functional [let alone structural...seriously?!] imaging in a sample of 20 clinical patients. That's a massive misjudgement of both the capabilities of MRI and the damage associated with even tremendous MDMA-abuse. Maybe I should introduce a few numbers here: MDMA-psychotherapy is conducted with 3 doses of 125mg/~2mg/kg (at Max.; this would be the 'full dose' in regards to psychoactivity) with weeks between doses; 5-HT neurotoxicity in pre-clinical studies can be demonstrated with regimens in the range of 10-20mg/kg [sic] IV, twice a day for 4 to 10 consecutive days; functional impairments in humans have been shown in users with hundreds to even thousands of expositions with Ecstasy (which can be pretty much anything) in completely uncontrolled settings - and with associated lifestyles. It is an obvious fact that Ecstasy-abuse (high dose and high frequency) is detrimental to mental health - no doubt. However the rationale of "this medicine is not safe because it is neurotoxic and must not be applied" completely disregards the basic principle of toxicology: "dosis facit venenum." Given the apparently high efficacy of the intervention, this rationale is unscientific and immoral (!) in my opinion.

2. Dude, /any/ of those tests measure some sort of memory function. That's why they were performed. How stupid do you think those researchers are? (like: "Hey our paradigm is controversial because there is evidence it could impair memory - let's just not measure that...^-^")

3. The question why MAMP and a whole range of other well-known neurotoxic amphetamines (along with Benzodiazepines) with no curative value whatsoever, are widely prescribed (especially) in the US is quite interesting; also the question on why ethanol, which is toxic to pretty much any structure in the human body (including and especially neurons), is freely available; or the questions regarding SSRIs' efficacy, side effects and withdrawal syndrome; and so on........those questions have nothing to to with the current topic besides pointing to the fact on how hypocrite this controversy is led. 217.200.150.57 (talk) 11:23, 31 October 2014 (UTC)

User 217:

Please restrict your comments to the content of the article if you want to be taken seriously here. Personal remarks are not appreciated, are against policy, and do not foster consensus development.

I am inclined to agree with you regarding the non-significant toxic effects of limited MDMA dosing. But I disagree strongly with your statement about high efficacy. What we have in this case is a result that is a priori unlikely, obtained by biased investigators in a small, unblinded trial. As a biotech investor, this is the kind of thing that I actively seek out in publicly traded companies as a prime shorting opportunity, as such results hold up in larger, better designed trials less than 5% of the time. Realistically I don't think this trial even belongs in the article. Formerly 98 (talk) 13:30, 31 October 2014 (UTC)

I stopped reading after the first two sentences of your reply; I've changed my mind - I'm not going to waste my time this weekend reworking that section. The article is fine as is; must feel great knowing such an incompetent editor rewrote an article on a topic near and dear to your heart, right? Seppi333 (Insert 2¢ | Maintained) 16:18, 31 October 2014 (UTC)

2001:62A:6:1:0:0:0:13 (talk) 22:56, 31 October 2014 (UTC) I should have bowed out, when it was time. ;) Sorry for going over the top Seppi! Seriously. @Formerly: Thanks for your comment! There are huge and unsolved methodological problems in this field. The problem is that those studies neither follow a pharmacological paradigm nor can they be investigated with the means of classic psychotherapy research (you see the results). The very nature of the paradigm brings with it that there are numerous confounders that cannot be controlled, that investigators must necessarily be biased [as in: /believe/ that the intervention is working. We're talking about psychotherapy here and the biggest factor of efficacy is still the therapist.] to do this kind of therapy at all and that blinding is simply impossible. However there is a lot of anecdotal evidence of unlikely or sometimes even miraculous results (acquired in formal settings), which is scientifically absolutely useless but motivates many. I suggest that we let this cool down for some time. If I find time to rewrite the paragraph I will post a proposal here. 2001:62A:6:1:0:0:0:13 (talk) 22:56, 31 October 2014 (UTC)

Might add a few tidbits of research here and there

I might over the next few days add stuff like bits of research and a few paragraphs in regards to MDMA's perceived risk level here and there to 'balance' this article out, since, for the most part, it seems to cherry-pick negative research a bit too much. The actual knowledge we have of MDMA seems to be for the most part uncertain since (to my understanding) there's not enough research being done with it due to its prohibited status.

What I'm trying to say is that most researchers are not certain about what MDMA's effect on the body truly is as of yet... while its neurotoxicity is undeniable, the actual harm that the drug poses to users is less well known and basing the whole article on a few bits of negative research here and there (when there's other research contradicting the research cited in this article) seems to violate the expected neutrality of this article.

The truth is that we don't know how much MDMA harms users and in what way, as other users have mentioned in this talk page, and for the article to say with certainty that MDMA is absolutely known to be harmful is just as fallacious as an article saying that MDMA is absolutely known to not cause any lasting harm: after all, there's not enough research to prove things either way (and the truth probably lies somewhere in the middle).

I therefore think it's important to cite more research that has been done with MDMA and to make it clear in the article that we just don't know what's going on as far as permanent harm goes with this substance, to state otherwise is misleading. It seems to me like there's a lot of cherry picked data here. --Ugriffin (talk) 17:52, 6 November 2014 (UTC)

As long as it's encyclopedic and your source(s) satisfy WP:MEDRS, you can add whatever you like. Most of the new refs are free; although if you don't have access to a new WP:paywalled one that I added, I can upload it for you. Seppi333 (Insert 2¢ | Maintained) 05:26, 7 November 2014 (UTC)

???

What's wrong with this article now? It seems so biased in the negative way. It's more negative than heroin, MDA and many other articles about more dangerous psychoactive substances. Previous versions wasn't perfect but much better. According to this article, those my friends, who has taken this substance, would be permanently retarded and addicted to it. If MDMA has neurotoxicy, it's subtle and more theoretical, and it's addiction in reality is nowhere the same as amphetamines because of serotonin depletion (users are unable to get high taking MDMA 3 days at row). Yes, MDMA can be addictive, but in completly different way. There is a reason, why Lancer ranked ecstasy as less dangerous substance than amphetamine and cannabis.

Why overdose effects section looks so large in comparision to recreational effects section? Overdose is a result of uncommon use of substance and is very rare.

--217.24.78.169 (talk) 10:56, 8 November 2014 (UTC)

Completely agree with you. MDMA is a panacea for all known human diseases. Seppi333 (Insert 2¢ | Maintained) 05:01, 9 November 2014 (UTC)

No, but MDA is. In MDA article neurotoxicity isn't even mentioned. --217.24.78.169 (talk) 10:15, 9 November 2014 (UTC)

Maybe, at least, there should harm reduction section. For example, that taking MDMA no more than 4 times a year user can greatly minimize neurotoxicy. Most people don't even now this and try to abuse this drug as amphetamine. Especially, that you in Wikipedia article compare it so much to other stimulants (that dopamine diagram, uh). Who, in reality, snort this drug like cocaine day after day? That is definitely the way to gain some permanent disabilities.

This article is all about pharmacology activity and how it SHOULD affect people. But there is no psychological, behavior information, how actually people are affected. Of course, social researches isn't valid for you, because most people is stupid in pharmacology, they are tricked and they just don't know, how they should react to this substance. Especially, in this case, where pharmacology and neurotoxicy isn't fully understand. --217.24.78.169 (talk) 10:15, 9 November 2014 (UTC)

There's no information in the article on its psychological and behavioral effects in a clinical setting because research into its medical use is still in its infancy; there have been a handful of relatively small trials with this drug. That's why medical reviews are calling for more clinical trials to determine its degree of efficacy and effects. On another note, everything in this article on neurotoxicity and neuroplasticity cites observational evidence in humans, not a theoretical model or animal studies. Seppi333 (Insert 2¢ | Maintained) 15:10, 9 November 2014 (UTC)

When did this page turn into a diatribe about harm?

Millions of people take MDMA every weekend and somehow very few of them are harmed -- but the Wikipedia page is all about harm, harm, and more harm. Perhaps it's because a US agency with a complete drug-war bias has funded hundreds of millions of dollars' worth of studies into potential harms of MDMA -- thus lots of published papers are all about harms -- thus there are lots of ways to cite many different studies about harms. But harm is by far the abnormal situation with MDMA; the vast majority of its users are never harmed.

It would be as if the Aspirin page spent 4/5ths of its text on bad side effects of Aspirin. But it doesn't. Or if the page on Stairs was all about injuries. But it isn't; in fact, it barely mentions them despite stairs being the cause of millions of injuries and 12,000 deaths per year in the United States. (see 2012 NEISS Highlights and search for Stair).

And why does the page include an almost completely irrelevant and overdetailed huge colorful diagram of some kind of brain chemistry, apparently coming out of this "psychostimulant addiction" template that doesn't even reference MDMA? MDMA is generally not considered an addictive drug! Alta Mira Recovery's list of most addictive drugs does not even include MDMA; various citations about addictive drugs see it as low in addictive risk.

Image+refs

Signaling cascade in the nucleus accumbens that results in psychostimulant addiction Note: colored text contains article links. Nuclear pore Nuclear membrane Plasma membrane Cav1.2 NMDAR AMPAR DRD1 DRD5 DRD2 DRD3 DRD4 Gs Gi/o AC cAMP cAMP PKA CaM CaMKII DARPP-32 PP1 PP2B CREB ΔFosB JunD c-Fos SIRT1 HDAC1 This diagram depicts the signaling events in the brain's reward center that are induced by chronic high-dose exposure to psychostimulants that increase the concentration of synaptic dopamine, like amphetamine, methamphetamine, and phenethylamine. Following presynaptic dopamine and glutamate co-release by such psychostimulants, postsynaptic receptors for these neurotransmitters trigger internal signaling events through a cAMP-dependent pathway and a calcium-dependent pathway that ultimately result in increased CREB phosphorylation. Phosphorylated CREB increases levels of ΔFosB, which in turn represses the c-Fos gene with the help of corepressors; c-Fos repression acts as a molecular switch that enables the accumulation of ΔFosB in the neuron. A highly stable (phosphorylated) form of ΔFosB, one that persists in neurons for 1–2 months, slowly accumulates following repeated high-dose exposure to stimulants through this process. ΔFosB functions as "one of the master control proteins" that produces addiction-related structural changes in the brain, and upon sufficient accumulation, with the help of its downstream targets (e.g., nuclear factor kappa B), it induces an addictive state.

References

Is some anti-drug bigot getting paid to manipulate Wikipedia articles? Gnuish (talk) 23:57, 10 November 2014 (UTC)

This anti-drug bigot uses amphetamine on a daily basis (so all substituted amphetamines are bad, mmkay?) and drew that image, which is based upon amphetamine's signal transduction. If you don't know why accumbal ΔFosB induction by MDMA (as noted in PMID 16957076) makes it an addictive drug, perhaps you should read ΔFosB (would also be worth knowing the definition of an "addictive drug"). Amphetamine and MDMA have common pharmacodynamics in DA neurons (actions at TAAR1, VMAT2, DAT); the only thing that varies is affinities to targets, which means that pathway reflects MDMA at sufficiently high doses as well.

If MDMA didn't have a mountain of evidence on its adverse neurocognitive effects, the article wouldn't have a section on that. In any event, I frankly really don't care about the "harm potential" of any drug; papers on that topic are basically subjective rants for or against drugs that try to push a policy position for legalization or regulation. I don't give an iota of a fuck about MDMA's legality (or drugs in general), but I do about the accuracy of medical information on MDMA. Nothing is going to change in the adverse effects or overdose sections, because that content is accurate and non-subjective.

I'm not going to bother arguing about this - I've said all I have to say. Seppi333 (Insert 2¢ | Maintained) 01:32, 11 November 2014 (UTC)

Most MDMA use habits happen because of MDMA activity on serotonin receptors. MDMA affects dopamine receptors, but dopamine role is onlf secondary. if amphetamine and MDMA is so similiar so why exactly EMCDDA annual reports shows that each year there is 20 times more amphetamine users in drug addiction treatment than MDMA users? You don't even mention that kind of data. This article is just your pharmacological interpretations. I won't argue more, because there will definetly be other people who will do this, and this article will be changed. --91.188.45.39 (talk) 17:35, 12 November 2014 (UTC)

Facepalm Seppi333 (Insert 2¢ | Maintained) 18:09, 12 November 2014 (UTC)

I have to agree with some of the sentiment that User:Seppi333 has taken over this article (and others besides), and imposed his/her opinions upon it. This edit, I think, is at the heart of the matter. If you are really as informed as you say you are, Seppi333, then you will know that any chemical can be neurotoxic at a high enough dose. I haven't had the time to look at all the studies you have brought to bear on this topic, but I am confident none of the studies showing histological evidence for MDMA neurotoxicity on particular receptor systems used human subjects. You should likewise know that the doses used in most animal studies are well in excess of typical recreational doses, and orders of magnitude above the subjective threshold dose. It's interesting that you disclose that you use amphetamines on a daily basis, and I can't help but thinking you might want to dial back the dose a bit. You are coming across as a bit manic. You keep insisting that you "don't give an iota of a fuck about MDMA's legality (or drugs in general)", but it is apparent that you care a lot about amphetamine drugs in general. I question your open-mindedness and scholarship. The pharmacodynamics of MDMA and pure amphetamine are not as similar as you make it sound. There is abundant evidence that MDMA is much more serotonergic than amphetamine. But that is another topic. I don't think "neurotoxic" should be the first descriptor of MDMA. As I've mentioned, the dose makes the poison. Furthermore, exitotoxiticy is mostly the result of glutamate, and even more proximally, Ca2+ ions. Now go change the article on Calcium to say: "Calcium is a neurotoxic element with atomic number 20." Cheers, -92.24.98.107 (talk) 16:49, 25 November 2014 (UTC)

Actually the animal toxicology studies are quite relevant and are comparable to those required by the FDA as part of prescription drug development and included in the package inserts of prescription drugs. And yes, they are always done at higher doses that human subjects would ever be exposed to in order to establish a margin of safety and pick up effects that would be too rare to pick up if the dose was limited to those actually encountered in people. The drug will be used by hundreds of thousands of people, and it is not practical to do animal toxicology in more than a few hundred animals. The physiological effects are observable on imaging studies, and the receptor studies you propose cannot be performed in human subjects (few are willing to volunteer for a study that requires donation of brain tissue). This is all pretty much standard toxicology.

An important difference between calcium neurotoxicity and MDMA neurotoxicity is that the calcium toxicity is secondary to head injury or stroke. And the calcium has to be there for function. MDMA is not required for function, and shows toxic effects in the absence of other insults. The comparison is really not even close.

We have asked for an outside opinion on this from an agreed upon neutral third party, and that person largely confirmed Seppi's conclusions. If you like, we can do an RFC at the Medicine Project, but I don't think it will go the way you want it to. The literature seems pretty clear on this issue. Formerly 98 (talk) 18:00, 25 November 2014 (UTC)

Er...I've pointed out MDMA is a direct neurotoxin; you're referring to an indirect neurotoxin (a toxin with a threshold). I've pointed out that I don't care about MDMA's legality exactly once, not repeatedly; although, in fact, I don't care about the legal status of drugs in general. If people want to be retarded and take a brain-borking substance, that's their prerogative IMO. (Now you can say I've said it repeatedly)

Btw: the obvious reason why MDMA has more affinity for serotonergic systems than amphetamine is that it has more affinity for SERT than DAT/NET relative to amphetamine, which allows it to access and bind to TAAR1 more readily within 5-HT neurons. You'd know that if you actually read TAAR1, in which I wrote an entire paragraph explaining that property of TAAR1 agonists. Seppi333 (Insert 2¢ | Maintained) 23:09, 25 November 2014 (UTC)

"I'm not even remotely interested in its legal status and don't even want to edit content on that". See, the problem is how sure you are of yourself, and I think, the literature. Most of the studies you cite are US government funded, obviously designed to show toxicity and other harm. Formerly 98 says human imaging studies can establish the specific neurotoxicity of a particular chemical! Ha. As Seppi333 would say "facepalm". There are so many confounds. People who use MDMA usually use a bunch of other drugs and typically don't have the healthiest lifestyles. Seeing volumetric or connectivity abnormalities in fMRI of some drug abusers is poor evidence. And, with respect, I know about the difference between direct and indirect toxicity, and the point that dosage is essential to that characterization still stands. Plus, the direct vs. indirect distinction is a bit messy anyway. Pure water is neurotoxic because it is extremely hypotonic. Inject a massive amount of pure H20 into someone's carotid artery and it will kill them very rapidly. Now is this effect direct or indirect? If it weren't for the high ion concentration inside the cells, the water wouldn't be toxic, this would imply indirect, the ions are directly responsible for the cell lysis. But wait, without the ions the cells don't function at all. And the same argument can apply to pH requirements of living cells, glutamate, calcium, ethanol, any chemical you can name. I'm fine with the article having neurotoxicity as a duly weighted section or subsection, it can even be mentioned in the lead. However placing the word neurotoxic as the first descriptor in the lead sentence is ridiculous. Personally, I don't think "empathogenic" should be in the first sentence either. What a joke. That term harkens to a day of alchemy and love potions. Just call it what it is, "...an amphetamine-class drug that acts primarily on serotonergic and dopaminergic neurotransmitter systems in the brain. It is used recreationally for euphoriant and empathogenic effects. Research has show that it can be neurotoxic and addictive." -92.24.81.232 (talk) 10:36, 26 November 2014 (UTC)

I've been watching this discussion. This is probably the last post like this that i'll allow to stand - future ones will be deleted. 1) Per the talk page guidelines, we discuss content, not contributors. Future posts commenting on contributors will be deleted. 2) This is not a forum for anyone to discuss their personal views. The next post full of personal opinions will be deleted. 3) Please focus discussion on content and sources. In other words, take each sentence in the body about neurotoxicity, look at its source, and evaluate whether the source is reliable per MEDRS and whether it supports the content. I have done so. If you find any problems, please feel free them to bring them up here on Talk, ideally one per section, as opposed to yet another wall of text. And please consider getting an account. There are several IP addresses active here and I for don't know if they are one person or several. Thanks. Jytdog (talk) 11:57, 26 November 2014 (UTC)

The lead sentence has been the topic of both (the two more recent ip posts in this thread) my comments. It just happens that one contributor in particular seems to be very adamant that we eschew the style of basically all other articles on psychoactive drugs on WP and lead with "MDMA is a neurotoxin". Of course there are dozens of studies that show some neurotoxic effect from MDMA, and said contributor cited many of them, making critique of those studies an overly laborious task. But, for example, "Single oral doses of 125 mg and 75 mg of 3,4-methylenedioxymethamphetamine, 40 mg of amphetamine, and placebo were given." -Mas M et al; J Pharmacol Exp Ther 290 (1): 136-45 (1999). In this study, the control dose of amphetamine was half the size of the smallest MDMA dose. There are similar methodological problems with every paper cited about neurotoxicity. Is MDMA neurotoxic? Yes, I have no doubt that it is. Should neurotoxicity be discussed in this article? Absolutely. Does it make any sense to describe MDMA primarily as a neurotoxin, as if that is it's intended use? No. It doesn't. And that isn't 'just my opinion'. Look at the first sentence of the introduction of any paper ever published on MDMA and if one of them reads: "MDMA is a neurotoxin..." or "MDMA is a neurotoxic..." then you might have a point. As it is now, this is an advocacy essay, not an encyclopedia article. It diminishes the credibility of all the valuable info presented below when the lead is structured as it is. -92.24.81.232 (talk) 14:13, 26 November 2014 (UTC)

the article doesn't cite " J Pharmacol Exp Ther 290". Please discuss content and sources that are actually in the article. Thanks. Also, if your point is about the lead, let's discuss the lead. If your point is to claim that the content and sources don't support the neurotoxicity of MDMA, let's discuss that. Jytdog (talk) 13:26, 27 November 2014 (UTC)

Sources/Neutrality/Fringe Theory

Recently flagged this for Neutrality issues. This article cites reviews from psychiatrists and psychologists cherry-picking many sources of medical data to present specific worldview, and are not ordinarily qualified to interpret such vast quantity of data outside of their respective fields as experts. Most of the data they look at has been agreed to be inconclusive within the scientific community. Furthermore, it appears that legitimate data has been erased from the article. The article itself seems to cherry-pick studies without the corresponding follow-ups and reviews to those studies in order to paint a specific agenda. The overall quality of many drug and health sections on wikipedia have since been, consequently, negatively impacted. The drug sections seem to incite panic and do not provide a rational understanding of the current available data. In order for Wikipedia articles to be taken seriously over the future, a more balanced approach is needed on these hot-topic issues as many are featured as the lead article on Google, even if they are not featured on Wikipedia. --Fiveonfive (talk) 00:49, 15 November 2014 (UTC) @Fiveonfive:, I think you'll understand our position a little better if you review WP:RS and especially WP:MEDRS. We have lots of debates of this sort here because the editors are a diverse group with a wide range of personal opinions. But what we have agreed as an organization is that 1) neutral point of view is the consensus of experts of the field, not the consensus views of Wikipedia editors, and 2) Reliable sources for determining what constitutes expert consensus are review articles and other secondary literature published in peer reviewed journals. By these standards, the content is neither fringe nor non-neutral. Formerly 98 (talk) 01:17, 15 November 2014 (UTC)

@Formerly 98:, OK, I hope you guys take it in the right direction --Fiveonfive (talk) 01:55, 15 November 2014 (UTC)

The most recent and largest high-quality study from Harvard University, funded by the National Institute on Drug Abuse for $1.8 million dollars, found the following:

"Findings- We found little evidence of decreased cognitive performance in ecstasy users, save for poorer strategic self-regulation, possibly reflecting increased impulsivity. However, this finding might have reflected a pre-morbid attribute of ecstasy users, rather than a residual neurotoxic effect of the drug."

"Conclusions- In a study designed to minimize limitations found in many prior investigations, we failed to demonstrate marked residual cognitive effects in ecstasy users. This finding contrasts with many previous findings—including our own—and emphasizes the need for continued caution in interpreting field studies of cognitive function in illicit ecstasy users."

This is the highest quality neurological/cognitive study of the subject to date.

--Fiveonfive (talk) 06:55, 15 November 2014 (UTC)

The two most common sources Parrott AC (2014) and Meyer JS (2013) cited in this article do not by themselves or together validate any theory that neurotoxicity arises from common mdma use. For the subject of neurotoxicity, the Parrott review focuses on a study of lower quality than that of the Harvard study, on interviewing poly-drug users whereas the Harvard study isolated sole ecstacy users, via hair testing and verbal confirmation. Unlike in prior studies- Both the control group and the ecstacy group attended raves and danced all night in the Harvard study as well (like I said, the highest quality study to date on the subject matter, commissioned by the National Institute on Drug Abuse). The Meyer review openly suggests that use associated with common dosages among users does not produce neurotoxic effects (Under "Neurotoxicity" in the review "the jury is still out"), which makes it an improperly-used and improperly-read source by he who put it there. This is on top of the fact that this review cites studies of lower methodological quality than that of the Harvard Study.

Here is the full excerpt from Meyer:

"Because animal studies of MDMA neurotoxicity have typically used large and/or repeated drug doses, we may ask whether one or a few modest doses of ecstasy are capable of exerting neurotoxic effects in users. This question has been addressed by several prospective studies of new ecstasy users participating in the Netherlands XTC Toxicity (NeXT) study. The results thus far have failed to show any serotonergic deficits in these low-dose users; however, other abnormalities were found related to brain vasculature and white matter structure. Thus, the jury is still out on whether damaging effects can be produced by consuming even a few ecstasy tablets"

I move to immediately remove language that suggests neurotoxic effects arise in humans from anything but near-death dosages, until any other high quality studies on humans come to light- that have not already been mentioned here.

--Fiveonfive (talk) 10:45, 15 November 2014 (UTC)

Why neutrality template is being constantly removed? Isn't it a vandalism? Neutrality is most definitely disputed. There is multiple persons against one (editor) that says that there is something wrong with this article (so much discussions in previous 2 weeks in the talk page). --217.24.68.165 (talk) 17:00, 15 November 2014 (UTC)

WP:NPOV requires us to give prominence to every point of view in proportion to their adherence among experts, and for medical content, WP:MEDRS requires us to assess the adherence among experts using secondary sources such as review articles published in peer reviewed journals. We don't assess the quality of primary research ourselves, but wait for review articles to see how the research is assessed by experts.

By these criteria, we probably cannot use the "Latest and Best Harvard Study" at all, let alone to establish consensus expert opinion. It is a primary research paper published in 2011. In the 2012 to 2014 interval, about 60 review articles were published on the subject of MDMA. As near as I can tell, the Harvard paper has not been cited in any of them. (Pubmed has a "this paper has been cited by" function in the lower right of the page).

For the functional tests, I'll leave that to Seppi as I believe those are his additions. But the imaging studies seems to clearly show a neurotoxic effect, and we know from studies of neurodegenerative diseases that frank symptoms often do not appear until neurological damage is fairly advanced. Tt seems very difficult to me to get away from describing this drug as neurotoxic in this article. ::Formerly 98 (talk) 18:30, 15 November 2014 (UTC)

At the very least, please remove the improperly cited source (Meyers JS). That source says the opposite of what it is being used for.

http://en.wikipedia.org/wiki/MDMA#cite_note-current_perspectives-13 --Fiveonfive (talk) 22:14, 15 November 2014 (UTC)

More from the Meyer's review (2013):

"Polydrug Use-

Ecstasy users are almost always users of other substances, including both licit (eg, alcohol and tobacco) and illicit (eg, marijuana, cocaine, methamphetamine, hallucinogens, and opiates). Polydrug use constitutes a major complication for interpreting studies of recreational ecstasy use, as it can be difficult to ascribe the results specifically to repeated MDMA exposure. Some investigators have attempted to deal with this confounding factor by statistically controlling for exposure to other substances of abuse. Another important approach, which is discussed below, is to perform experimental animal studies in which pure MDMA is administered to animal subjects with controlled dosing regimens. Laboratory studies have also permitted an analysis of the acute effects of MDMA in humans; however, simulation of heavy recreational ecstasy exposure cannot be performed for ethical reasons.

Several different patterns of ecstasy polydrug use have been identified. For example, analysis of data from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) revealed three subtypes of ecstasy users: 1) extensive use of many different drugs of abuse (37% of ecstasy-using respondents); 2) heavy marijuana and cocaine use with moderate use of amphetamines, including ecstasy (29% of respondents); and 3) heavy marijuana use along with a low use of prescription drugs, primarily opiates (23% of respondents). The majority of category 1 respondents were found to suffer from multiple substance-use disorders involving tobacco, alcohol, cocaine, hallucinogens, and/or marijuana. The frequent co-occurrence of ecstasy and marijuana use has been confirmed in more recent studies and, therefore, is of particular concern, as chronic cannabis exposure has been associated with some of the same cognitive deficits and mood changes observed in heavy ecstasy users."

Fiveonfive (talk) 23:15, 15 November 2014 (UTC)

If you read the entire Neurotoxicity section of Meyer's it basically outlines the fact that most of the theories behind neurotoxicity are just that, theory. And yet to be proven. Given only that we have data from lab animals and not humans under the same conditions (with the exception of small samples of poly-drug users), he argues, no reliable conclusion can be made from the existing data. His own conclusion, cited by this article as a source of conclusive evidence, is that the debate is inconclusive, yet the article writes otherwise.. Fiveonfive (talk) 23:43, 15 November 2014 (UTC)

I know you're trying to be reasonable here and all, but I'm still having a hard time seeing your point. You quoted the section:

"Because animal studies of MDMA neurotoxicity have typically used large and/or repeated drug doses, we may ask whether one or a few modest doses of ecstasy are capable of exerting neurotoxic effects in users. This question has been addressed by several prospective studies of new ecstasy users participating in the Netherlands XTC Toxicity (NeXT) study. The results thus far have failed to show any serotonergic deficits in these low-dose users; however, other abnormalities were found related to brain vasculature and white matter structure. Thus, the jury is still out on whether damaging effects can be produced by consuming even a few ecstasy tablets"

I don't think that last sentence really rules out the idea that the drug is neurotoxic, just as the near zero likelihood of getting cancer from smoking 1 cigarette a week for 3 months is an argument that cigarette smoke is not carcinogenic. Its a little hard for me to follow the author's reasoning here: Isn't "abnormalities in white matter structure" a sign of toxicity? It certainly doesn't sound like something that I would want. I think this study could potentially be quoted to say that obvious cognitive deficits were not seen in a short term study of low dose users. I wouldn't want to go a lot further than that unless you find a better reference. Your second quote is a good one in that it points out the confounding issue (these almost always are present to some extent in any tox study other than a randomized clinical trial.) But there are other studies such as:

"A more refined 2010 meta-analysis by Nulsen et al differentiated between tests of short-term and working memory (verbal and visuospatial in both cases) and found that the ecstasy users performed more poorly in all memory domains. Results were significant regardless of whether the control group was composed of non-ecstasy polydrug users or individuals who had not been exposed to any illicit drugs."

Finally, he concludes with

"Although it is not yet clear whether a few MDMA doses are harmful to the user, heavier use has been associated with significant mood changes and cognitive deficits. Another major concern is possible serotonergic dysfunction produced by repeated and/or high doses of the drug."

Formerly 98 (talk) 23:49, 15 November 2014 (UTC)

Thank you for bringing those points up. The first section you referenced, is the last paragraph of the Meyer's review for neurotoxicity as well as it's conclusion on the topic of neurotoxicity. Neither the Meyer study nor the other excerpts you brought up rule out the possibility of neurotoxicity from the subject. They both however say "it is not yet clear" (to quote one of your excerpts) whether it harms the user, for lack of sufficient data to prove one way or the other. This is why I have held that the current scientific consensus is that the topic is "inconclusive". Fiveonfive (talk) 00:07, 16 November 2014 (UTC)

I'm sorry, I didn't see the part about heavier users in your second excerpt. These excerpts are taken from the "Neuropsychological deficits" section however, and related conclusion about neuropsychological deficits specifically, which are separate from the "Neurotoxicity" section. The cognitive deficits described are also discussed in the Neurotoxicity section under that section's context.

--Fiveonfive (talk) 00:53, 16 November 2014 (UTC)

No worries, we'll sort it out.

I must admit I find the organization of the paper odd. If you use a drug and get cognitive deficits as a result, is that not neurotoxicity?

I believe the "unclear" remark you refer to is limited to the case of "a few doses".

In this case we have several lines of evidence of toxicity, including the meta analysis which found a significantly higher level of cognitive dysfunction in MDMA users compared to a control group of non-MDMA polydrug users; 2 prospective studies of new MDMA users; and boatloads of animal toxicology studies. Meyer concludes his article by saying that heavy use is associated with cognitive defects.

If you want to add the sentence I suggested about no cognitive defects seen in short term, low dose users, that is fine with me. Beyond that I think we need to do an RFC and get broader community input. If you want to go that way, I suggest the simple (and I think neutral) wording: "Do reliable medical sources show MDMA to be neurotoxic?" Your thoughts? Formerly 98 (talk) 01:05, 16 November 2014 (UTC)

I do not believe that cognitive deficits are necessarily always equivalent to neurotoxicity, but they are not a positive either.

I like both of your ideas, and agree that an RFC would be a good way forward. I like the wording you chose: "Do reliable medical sources show MDMA to be neurotoxic?".

Out of sheer curiosity, is caffeine considered to be a neurotoxin? I know that it causes cognitive deficits with regards to its effects on dopamine.

Also, some more interesting text from the Meyer review which i'm sure is to complicate the picture even further (finding from animal studies):

"Finally, prior exposure to low-to-moderate doses of MDMA can blunt or even prevent the neurotoxic effects of a subsequent high-dose treatment regimen. It is not yet known whether this effect, which has been termed “MDMA preconditioning,” applies to human recreational ecstasy users."

--Fiveonfive (talk) 05:19, 16 November 2014 (UTC)

Crazy stuff. I think that caffiene would be considered neurotoxic only if there were effects that persisted after the drug was cleared from the system. The RFC process is here https://en.wikipedia.org/wiki/Wikipedia:Requests_for_comment#Before_starting_the_Request_for_comment_process but I am going to bed. If you want to start it great, otherwise I'll do so tomorrow. Formerly 98 (talk) 05:38, 16 November 2014 (UTC)

Sounds good. I'll let you handle it. As far as neurotoxicity in animals, we should also avoid attributing results of animal studies onto humans as conclusive. See Olney's lesions. Fiveonfive (talk) 05:48, 16 November 2014 (UTC)

We should pick some references to cite in the RFC to make it easy for people. I suggest Myer and Parrott. Formerly 98 (talk) 12:22, 16 November 2014 (UTC)

Do with it as you see fit. I still think that saying it's neurotoxic is jumping to conclusions, as even the bearish medical reviews avoid saying outright that neurotoxicity happens in humans, and only can be proven in animals (with completely different biology) at ultra-high mg/kg doses. There are valid questions to contradictory data- a lot with low methodological quality. The National Institute for Drug Abuse website (government run) avoids mention of the word 'neurotoxicity' anywhere in accordance- normally the most hawkish entity of all and a sure sign the debate is still undetermined. --Fiveonfive (talk) 12:02, 18 November 2014 (UTC)

Alright, I have to admit that I'm feeling a lot less strongly about this than I was a few days ago. If you agree, maybe I'll just ask jytdog to give us a third opinion. He's a medical editor who is very fact oriented, and to the best of my knowledge has no history of editing recreational drug articles or any strong opinions on the subject. You can look at his editing history and let me know what you think. Formerly 98 (talk) 13:26, 18 November 2014 (UTC)

I haven't had much time over the past few days to get on WP, but my thoughts are to just get a 2nd opinion from the uninvolved as suggested. Seppi333 (Insert 2¢ | Maintained) 20:51, 18 November 2014 (UTC)

Jytdog looks solid, and impartial Fiveonfive (talk) 00:38, 23 November 2014 (UTC)

I left a note on his page. Formerly 98 (talk) 02:08, 23 November 2014 (UTC)

hi, i am all flattered. i will do my best to help you! i read the article and its sources, and then I read the discussion above, and it is not clear to me exactly what is being disputed. Is there some particular content that somebody wants to change? if so what and how? thx Jytdog (talk) 02:44, 23 November 2014 (UTC)

Since Seppi edited this, there have been several complaints about the prominent description of MDMA as neurotoxic and/or the extent of its putative neurotoxicity and the weight put on the issue in this article. So we put to you: Is MDMA neurotoxic? Is the toxicity, if present, severe enough to merit the weight put on it in this article? Formerly 98 (talk) 03:58, 23 November 2014 (UTC)

I think it should be expanded to (possibly with it's own section)--- The exact characterization of neurotoxicity in distinctions between animals, humans vs. low, moderate, and high dose users and vs. low, moderate, and high dosage frequencies. The scientific consensus and conclusiveness of the various distinctions described in regards to general and long-term neurotoxicity. What Formerly 98 said also, this is a complicated issue as revealed by our discussion Fiveonfive (talk) 04:25, 23 November 2014 (UTC)

fiveonfive you should have a look at WP:MEDMOS for style and WP:MEDRS for sourcing (it also talks about style). granted they are both thin for toxicity content, but they nonetheless inform how we write about all health-related matter. we read the best and most recent secondary sources we can find and paraphrase what they say. we do not go at this like it a scientific review article and rehearse all the data - we write for the general reader and we provide the consensus of the field. based on my review of the sources in this article (and i checked to see if there were any newer or better ones), neurotoxicity is probably the most important risk of this drug. (btw it is a powerful drug. there is no drug that isn't toxic and generally the higher the dose and the longer you take it, the more toxic any drug is). based on what i read, there have not been the kind of rigorous phase I/phase II studies you need to get a good handle on the "therapeutic window" (if we can even discuss that for a recreational drug) so we don't know the dosing at which the side effect profile (short term and long term) would be acceptable. and btw, many toxicities are short-lived. the brain is plastic, somewhat. anyway, it is a ~little~ too harsh and too detailed now but not by a lot. if i were to get active on this article i would reduce the size of the adverse section which is laundry-listy and I would get rid of the discussion of animals in the neurotox section too. Jytdog (talk) 04:56, 23 November 2014 (UTC)

i see. still learning about wikipedia's processes. thanks for the assistance.

looking forward to seeing your balancing of the article and I appreciate your dedication to being impartial, as well as Formerly 98's.

Fiveonfive (talk) 05:47, 23 November 2014 (UTC)

I think that Formerly 98's characterization of the issues presented in this article, are accurate in depicting what most people expressing issues with this article feel. There is also a very small section dedicated to immediate risks,

such as mdma's heat-trapping effect which produces hyperthermia in hot environments that leads to liver failure, kidney and organ failure and possibly death (which is not thoroughly explained as well as understated). These are the conditions most people taking this drug are found in (raves). That same line (hyperthermia) connects low sodium/water intoxication to hyperthermia which should be better clarified to explain how the two phenomenon are connected in layman terms. Water intoxication and low electrolyte balance is another immediate risk in itself, that should also be given greater weight as it is attributable to a few deaths and more sicknesses during recreational use. Lastly, not enough emphasis is put on adulteration of the substance within the article, which is implicated in almost every overdose that occurs and is the single greatest threat with recreational mdma use, especially when substances are combined with mdma. These are all the things people die from related to its use. As well, Mdma's psychadelic effects are most closely associated with the effects of mescaline, in the general section. I'll post more as I find, will edit with sources when i have time.

-Fiveonfive (talk) 07:07, 23 November 2014 (UTC)

Even though Parrott AC offers a rebuttal to this (to save his reputation), his very review is being disputed in the medical community. Is this the best source to base the majority of the article on?

http://www.ncbi.nlm.nih.gov/pubmed/24590541 Fiveonfive (talk) 10:37, 23 November 2014 (UTC)

ill let you guys have it. Too painfully boring for my taste. Fiveonfive (talk) 07:55, 24 November 2014 (UTC)

Source on retrospective quality issues http://www.nature.com/npp/journal/v37/n4/full/npp2011202a.html#bib2 Fiveonfive (talk) 01:59, 29 November 2014 (UTC)

References

Words and Graph Say Different Things

Underneath the pretty graph with the 20 bubbles, it says, "Addiction psychiatrists were polled regarding 20 popular recreational drugs; ecstasy was ranked 16th in addictiveness and 12th in harmfulness." However, that's not what the graph says. It says it was ranked 16th in both categories. If the graph is right, E is not as harmful as the words say.

174.92.77.189 (talk) 03:48, 17 November 2014 (UTC)

It looks like you are right. The raw data is here http://commons.wikimedia.org/wiki/File:Rational_scale_to_assess_the_harm_of_drugs_(mean_physical_harm_and_mean_dependence).svg and the paper is here http://www.antoniocasella.eu/archila/NUTT_2007.pdf. Sorting the mean dependency, physical harm, and social harm columns shows ecstasy to be ranked 16th in all categories. I'll change this when the edit lock is lifted unless someone else does so before me.50.106.202.195 (talk) 06:47, 19 November 2014 (UTC)

WP:COPYVIO in refs

somebody has put HUGE quotes in references. In my view several of those go way way beyond fair use. please cut them down and keep them down to a (non-German) sentence or two. Jytdog (talk) 04:58, 23 November 2014 (UTC)

Examine this page. Note that the entire page is composed of excerpts from research papers and hosted on a US government website. Seems a bit heavy handed to call the use of quote parameters for text exactly like they do a WP:COPYVIO. Seppi333 (Insert 2¢ | Maintained) 05:09, 23 November 2014 (UTC)

yes, otherstuff exists. and who is going to sue the US government for infringing copyright of work they probably paid for? Please don't include long excerpts from copyrighted texts in WP. You know this is not OK. Jytdog (talk) 06:17, 23 November 2014 (UTC)

Actually my point is it is OK to quote excerpts from copyrighted sources in the context of a review. You should probably familiarize yourself with this aspect of copyright law if you're going to delete content on those grounds. FYI, the US government doesn't pay authors to write for pharmacology textbooks. Seppi333 (Insert 2¢ | Maintained) 13:20, 23 November 2014 (UTC)

While you all are discussing, in good faith, whether this material is suitable, I've removed it and locked the article in that state because WP:EW is unacceptable behavior on its face. There's no damage to having it not-there for a few days while you sort it out, and it's visible in the history so everyone can see what's being discussed. But it's less damaging to leave it out for now (annoying absence vs licensing policy violation), and I'm surprised that someone would edit-war to include a potential policy violation. DMacks (talk) 13:38, 23 November 2014 (UTC)

My 2¢: I could a list of a few dozen articles with said "copyright violation", some of which have gone through thorough reviews; this is an asinine tangential road we're going down. Seppi333 (Insert 2¢ | Maintained) 13:45, 23 November 2014 (UTC)

seppi, i suggest you strike the "asisine" comment. I get it, that you think, in good faith, that your use of lengthy quotes is totally fine. I don't, and ask that you respect my good faith. I've not been in a dispute before, about whether or not something violates copyright. It appears that the only option for bringing in other voices is to post Wikipedia:Copyright problems which puts it into an administrative process, rather than offering an opportunity to discuss. I'd rather not go down that road. please see WP:COPYQUOTE, where it says that in an extreme case, a quote of 400 words from a 500 page book was found in court to be infringement. in this dif i removed a quote of about 500 words. . Can we come to agreement on a reasonable length limitation? Jytdog (talk) 16:54, 23 November 2014 (UTC)

I didn't revert that deletion because I agree that it was exceptionally long. We probably can come to a limit agreement given that I agree with you on that style point. Seppi333 (Insert 2¢ | Maintained) 18:25, 23 November 2014 (UTC)

thanks for the strike, and for compromising  :) Jytdog (talk) 19:50, 23 November 2014 (UTC)

PTSD paragraph

I cut the following and am pasting here. we need to find WP:SECONDARY sources for this:

An unblinded, single center pilot study of MDMA therapy in 20 post-traumatic stress disorder (PTSD) patients performed by the staff of MAPS – an organization advocating medical uses for psychedelics and marijuana – reported positive results that persisted in an open-label follow-up study performed several years later. A second study with 12 participants marginally failed to demonstrate a statistically significant effect.

parking here for now. Jytdog (talk) 19:34, 24 November 2014 (UTC)

I doubt there are any reviews out considering the limited amount of research done so far. Perhaps we should just comment that there is PTSD research in progress as NIDA does here http://www.drugabuse.gov/publications/drugfacts/mdma-ecstasy-or-molly. 50.106.202.195 (talk) 01:51, 25 November 2014 (UTC)

Some, possibly all, of those are covered in Parrott's and Meyers' reviews IIRC. I'll check tomorrow. You want me to email you any papers btw? Seppi333 (Insert 2¢ | Maintained) 03:43, 25 November 2014 (UTC)

thanks seppi i have access to pretty much any medical article. Jytdog (talk) 05:32, 25 November 2014 (UTC)

No direct dehydration

As far as I can tell, the existing literature, including the references cited, do not support the idea that MDMA causes dehydration. It seems that dancing causes dehydration and MDMA may mask thirst. I suggest we remove dehydration as an effect of MDMA.

In addition, the following sentence is incoherent, self-contradictory, and badly needs revision: "The most serious short-term physical health risks of MDMA are hyperthermia and dehydration;[25][29] this is due to a life-threatening complication – hyponatremia (excessively low sodium concentration in the blood) – associated with drinking large quantities of water without replenishing electrolytes.[25][29][30]"

173.228.54.200 (talk) 07:23, 25 November 2014 (UTC)

I'm still confused after reading this section several times. Does MDMA somehow prevent users from sweating when their body temperature rises? (Hint: The answer is no). All the refs quite clearly support that statement. What exactly do you think is wrong with the sentence on hyponatremia? Seppi333 (Insert 2¢ | Maintained) 05:50, 26 November 2014 (UTC)

The main issue with the hyponatremia sentence is that dehydration cannot be caused by hyponatremia, which the sentence claims, since the two clinical states are opposites. 173.228.54.200 (talk) 06:11, 26 November 2014 (UTC)

That sentence says hyponatremia is the result of responding to dehydration by drinking a lot of water. It's referring to dilutional hyponatremia. Seppi333 (Insert 2¢ | Maintained) 06:16, 26 November 2014 (UTC)

CYP2D6

The page currently says that CYP450 is important, "especially CYP2D6". But clinical studies by de la Torre and colleagues show that MDMA inhibits CYP2D6, which greatly limits its contributions to MDMA metabolism. What justification is there for the word "especially"? I suggest we change it to "including". 173.228.54.200 (talk) 07:36, 25 November 2014 (UTC)

"CYP2D6 is the major enzyme involved in the oxidative metabolism of MDMA that in turn produces metabolites of recognized toxicity." – PMID 22392347 Seppi333 (Insert 2¢ | Maintained) 22:40, 25 November 2014 (UTC)

That sentence isn't responsive, as the sentence states that 2D6 is the major enzyme producing toxic metabolites. The sentence does not say 2D6 is the major enzymne. In any case, see, for example, http://www.ncbi.nlm.nih.gov/pubmed/23162568 and http://www.ncbi.nlm.nih.gov/pubmed/23112822 I think the review is probably too old to reflect current knowledge. 50.250.213.37 (talk) 23:50, 25 November 2014 (UTC)

Substituted amphetamines are generally both inhibitors (even if only competitive) and substrates of CYP2D6. In any event, I don't have a problem with the proposal, so I'll change it as requested. Seppi333 (Insert 2¢ | Maintained) 00:04, 26 November 2014 (UTC)

Why was melting point removed from box?

I added a melting point range for MDMA, which was removed by another user, because it did not have a reference. I then added it back with a reference. Then the entire section was removed. I suggest we add melting point back into this page. It is a little disheartening to have objective, referenced information arbitrarily removed. 173.228.54.200 (talk) 07:39, 25 November 2014 (UTC)

remove the information you edit warred into the article and i will be happy to talk with you. i am dealing with too many crazy people tonight. Jytdog (talk) 07:48, 25 November 2014 (UTC)

I'm not certain what you mean? I am trying to add referenced information and improve uncited and incorrect information. What do you want removed, please discuss here instead of reverting good faith edits. 173.228.54.200 (talk) 08:02, 25 November 2014 (UTC) I propose adding melting point back into the box with a reference to Shulgin's work and using the lowest and highest numbers he gives while specifying that mp varies depending on hydration. 173.228.54.200 (talk) 05:03, 26 November 2014 (UTC)

Unsupported claim of 'safer' unapproved and unproven treatments

This statement does not appear to be supported by the reference: "The author noted that oxytocin and D-cycloserine are safer co-drugs in PTSD treatment" I did a search of the paper for both drugs and did not find them mentioned. Moreover, neither drug has been approved as safe and efficacious. I suggest we reword to something like: "While oxytocin and D-cycloserine are potentially safer co-drugs in PTSD treatment, they have not been approved for this indication by any regulatory body." 173.228.54.200 (talk) 07:54, 25 November 2014 (UTC)

...Look at the abstract. See also the content under the heading "SAFER DRUGS FOR POST-TRAUMATIC STRESS DISORDER THERAPY". Seppi333 (Insert 2¢ | Maintained) 22:37, 25 November 2014 (UTC)

Ohhh, you're right. I was looking at the wrong pdf! Thanks for the correction. In any case, I think my point stands that the page should not appear to endorse a non-clinician's untested opinion about the safety of unapproved drugs. D-cycloserine has serious neurological and psychiatric side effects, not clearly better than MDMA or amphetamines. Neither drug that author mentions has been shown to be efficacious. I think it would be best to remove the reference to D-cycloserine and oxytocin. Failing that, I suggest clarifying that they have unknown safety and efficacy and are not approved for this indication. 173.228.54.200 (talk) 04:39, 26 November 2014 (UTC)

That's fair. I'll tweak the language as suggested. Seppi333 (Insert 2¢ | Maintained) 05:12, 26 November 2014 (UTC)

No evidence of experiments as interrogation tool

This sentence is not supportable: "The Army experimented with MDMA as an interrogation tool in Project MKUltra." The Army did preclinical toxicity studies with MDMA (Harman et al) after they killed someone in research with MDA. But there is no evidence in the literature that they experimented with MDMA as an interrogration tool. Moreover, the book being cited explicitly says this in the chapter co-written by Grob. The citation seems to use irrelevant page numbers. I suggest changing this statement and, in general, when books have different authors for each chapter, the chapter should be cited. 173.228.54.200 (talk) 08:24, 25 November 2014 (UTC)

I never edited this section, but if it can't be verified, it should be deleted. Seppi333 (Insert 2¢ | Maintained) 05:30, 26 November 2014 (UTC)

Done.173.228.54.200 (talk) 06:06, 26 November 2014 (UTC)

Lack of appropriate reference for MDA as "direct neurotoxin"

I noted a citation was needed for the claim that MDA is a "direct neurotoxin". The reference added by Seppi333, actually a compendium of abstract-style summaries of primary literature, does not seem to support the claim. The first appearance of the word MDA claims to be a peer reviewed citation, but it's actually an unreviewed government website and the word "MDA" appears to be a typo:

"Research shows that MDA destroys serotonin-producing neurons in the brain, which play a direct role in regulating aggression, mood, sexual activity, sleep, and sensitivity to pain. It is probably this action on the serotonin system that gives MDMA its purported properties of heightened sexual experience, tranquility, and convivality. [National Institute on Drug Abuse (NIDA) Infofax on ECSTASY. Available from http://www.nida.nih.gov/Infofax/ecstasy.html on Wednesday, May 17,2000] **PEER REVIEWED* "

This is obviously not peer reviewed. The linking of MDA in the first sentence with "this action" in the second makes it clear that MDA is a typo and that they meant to write MDMA. Moreover, the sentence about MDA does not appear on the website, as far as I can tell. I suggest that Toxnet be deprecated in favor of more reliable refernces. The vast majority of the papers it mentions seem to be about MDMA and many describe NIH-funded studies where volunteers were given MDMA. The only other mention relevant to MDA toxicity I see seems to state the opposite of the original claim:

"Direct injection of either 3,4-(+/-)-methylenedioxymethamphetamine (MDMA) or 3,4-(+/-)-methylenedioxyamphetamine (MDA) into the brain fails to reproduce the serotonergic neurotoxicity seen following peripheral administration."

I propose adding in the citation needed tag or removing the sentence, which has only peripheral relevance since it isn't about MDMA. 173.228.54.200 (talk) 04:56, 26 November 2014 (UTC)

I corrected the issue with species earlier which had been incorrectly stated. The current version is in accordance with the source, so I'm not going to revise this further. Seppi333 (Insert 2¢ | Maintained) 05:10, 26 November 2014 (UTC)

I'm sorry, can you clairify what you mean by "the issue with species"? I have pointed out that the references you gave do not support the claim the MDA is a neurotoxin. Do you believe they do? 173.228.54.200 (talk) 05:16, 26 November 2014 (UTC)

https://en.wikipedia.org/w/index.php?title=MDMA&diff=635435983&oldid=635414760 - notice the timestamp relative to your post. I'm not sure what the issue with the current revision is. Seppi333 (Insert 2¢ | Maintained) 05:22, 26 November 2014 (UTC)

Actually, given that this is nonhuman animals, I'm just going to delete the clause. Neurotoxicity in animals doesn't necessarily reflect upon humans by any means. Seppi333 (Insert 2¢ | Maintained) 05:37, 26 November 2014 (UTC)

The issue was that the reference does not support any neurotoxicity from MDA, only MDMA. And I have a secondary concern that the reference is unreliable since it claims un-reviewed goverment websites were peer reviwed and it has important typos. I suggest Toxnet be depricated as a reference. 173.228.54.200 (talk) 05:38, 26 November 2014 (UTC)

Toxnet satisfies WP:MEDRS. Trying to argue this point is going to get you nowhere. Seppi333 (Insert 2¢ | Maintained) 05:40, 26 November 2014 (UTC)

Interesting. Can you explain how Toxnet fits that WP? It isn't clear to me that it does. And it appears to me that its value is questionable. The first thing you/they cited mentioned the wrong drug through a typo and claimed an unreviewed web article was peer-reviewed. How can this be alleged to be reliable? And there seems to be no recourse for correcting it: In the FAQ, Toxnet says that non-Pubmed parts cannot be corrected because they are not produced by the NLM. Regards, 173.228.54.200 (talk) 05:51, 26 November 2014 (UTC)

I'm not going to argue over this. Ask about the source here if you actually want to push the issue: WT:MED. Seppi333 (Insert 2¢ | Maintained) 05:56, 26 November 2014 (UTC)

Done. Thanks for the pointer. 173.228.54.200 (talk) 06:05, 26 November 2014 (UTC)

I agree that Toxnet is not a reliable source per WP. It obscures the actual sources. SaltyRide (talk) 04:54, 11 March 2015 (UTC)

Addiction section is too narrowly focused on one lab's theories of a single mechanism

The research on addiction with MDMA that I have seen primarily documents sign and symptoms in users. It therefore seems strange to direct the reader to a "main page" about ΔFosB. This appears to be a strong endorsement of Nestler lab theories about addiction. If anything, a section on MDMA addiction should send users to a more broad article about addiction that addresses clinical issues. It appears to be a theory of this section that clinical issues with MDMA are analogous to those of psychostimulants. This seems to me to be unproven and possibly original research. It's well established that MDMA release of DA is largely indirect (which is why SSRI treatment reduces it in in vivo microdialysis), which distinguishes it from methamphetamine or amphetamine. I suggest that discussion of ΔFosB should be limited to one sentence and the diagram removed because it has not been demonstrated that the Nestler lab theories are correct or that these mechanisms explain clinical phenomena in MDMA users. 173.228.54.200 (talk) 05:34, 26 November 2014 (UTC)

Rofl. Seppi333 (Insert 2¢ | Maintained) 05:38, 26 November 2014 (UTC)

I suspect your Rofl violates WP:NoRofl But seriously, I think that section has big issues. Regards, 173.228.54.200 (talk) 05:57, 26 November 2014 (UTC)

Oh...you weren't joking were you? Seppi333 (Insert 2¢ | Maintained) 06:03, 26 November 2014 (UTC)

semi-protection

I've had it with the tendentious editing from IP addresses. I've requested semiprotection. Jytdog (talk) 07:13, 8 December 2014 (UTC)

 Done. I made it indef not because I think it should be infinite, but because it's a long-term problem and the good-faith editors need an uncertain amount of breathing room to see if there are any improvements at hand. No objection (== "need not consult with me first") to other admins converting to indef/long-term pending-changes or setting an endpoint to the semi. DMacks (talk) 07:24, 8 December 2014 (UTC)

thank you! Jytdog (talk) 08:59, 8 December 2014 (UTC)

Thanks DMacks. I was about to request this myself - both methamphetamine and amphetamine are permanently semi-protected anyway, so there is a precedent for an indefinite lock here. Seppi333 (Insert 2¢ | Maintained) 09:36, 8 December 2014 (UTC)

Synthetic routes

Its fine to have a sentence or two about how organic compounds are synthesized, but we generally do not provide the level of detail that was added here per WP:NOTAGUIDE. In the case of referring to specific named organic reactions and reagents, this sort of thing goes way over the head of 99% of our readers in any case. And as one of the 1% who does understand this material, I'd generally go to other sources and not Wikipedia when looking for synthetic information.

Yes, you can find examples of fairly detailed synthesis descriptions in some articles, but these are generally removed within a day or so of being added as I have here, for the above reasons. See for example the diffs below.

https://en.wikipedia.org/w/index.php?title=Tetracycline&diff=639920650&oldid=639815940 https://en.wikipedia.org/w/index.php?title=Benzoctamine&diff=prev&oldid=640281520 https://en.wikipedia.org/w/index.php?title=Lometraline&curid=35642404&diff=640281098&oldid=640264636 Formerly 98 (talk) 08:42, 1 January 2015 (UTC)

I don't personally care as long as we are consistent with similar articles. Methamphetamine also has a pretty substantial synthesis section which should be pared down under this reasoning.Sizeofint (talk) 09:45, 1 January 2015 (UTC)

Well, I tried to trim that out and got slapped down, as it has been designated a "Good Article". So I am going to back off a little bit here and just ask that you try to keep a cap on the technical details and name reactions. Thanks for the discussion. Formerly 98 (talk) 13:53, 1 January 2015 (UTC)

Alright, I will add it back in and see if I can simplify the section. Sizeofint (talk) 23:56, 1 January 2015 (UTC)

I added my thoughts on synthesis sections in articles like MDMA here: Special:Permalink/640752702#Synthesis section. I personally don't really care if such a section is included in a few articles like this, but it may be worth starting the dialogue I mentioned to establish a concrete policy on the coverage of synthesis routes in articles on US/UN schedule 1 controlled substances (globally banned chemicals). Seppi333 (Insert 2¢ | Maintained) 04:05, 3 January 2015 (UTC)

Image in header

There seems to be an edit war over which image this article should use. The top one shows the double bonds but the bottom one shows some hidden atoms. Anyone have comments regarding this.

File:MDMAPNG2.png

Sizeofint (talk) 19:45, 8 January 2015 (UTC)

I don't want to say a lot to sway public opinion on this. I appreciate the call to discuss. If you look at the top picture, the hidden atoms are not entirely hidden. You have to view the larger resolutions to see them clearly but they are at least partially visible, it's because of the angle of the image that they're not as obvious in the thumbnail. Lazord00d (talk) 16:58, 9 January 2015 (UTC)

The top image does not accurately depict the bonding in a benzene ring, showing alternating single and double bonds. The bottom image, which I made some years ago, shows the the C-C bonds in the ring are more or less equivalent in length and strength. I would strongly encourage those without a strong chemistry background not to get involved in making molecular models, as it leads to inaccuracies like this. --Ben (talk) 18:32, 10 January 2015 (UTC)

I agree with Ben. I have no objection to using normal single/double-bond styling for regular skeletal diagrams (the top), even though the bonds are not truly like that. But if one were to use them in any sort of more sophisticated style that includes geometry, every bond-length in that ring must be equal and the presence of the "second" bond of a double bond should not displace the position of the "first" bond (note that these detail is true even in the single/double diagram). It's okay not to know that this ring is not actually single and double bonds, and it's okay in some contexts to illustrate it that way, but anything built on top of that factually flawed detail becomes increasingly incorrect--and visibly so--in many ways. See benzene and aromaticity to learn more. The double-bonds really approximately do circulate around the ring, as the lower diagram illustrates, and the perspective is better in that the back atoms are more readily visible even at thumbsize. DMacks (talk) 20:12, 10 January 2015 (UTC)

Okay, if there aren't any objections in the next day or so I'll switch the image to the bottom one. Sizeofint (talk) 00:19, 11 January 2015 (UTC)

The bond lengths in the images I've submitted are determined by the software's built-in algorithm and the size settings for the atom diameter.. as I didn't write it I can't speak for it's accuracy, however jmol is well known and I trust its programmers much more than any reference in this thread I can say that for sure. Also, even though the points about aromaticity are factual, my position is that the fact that the stick and ball models I've submitted are closer to the 2d model makes them more easily understood. I can't support reverting based on that criteria but this is a public forum so it's not up to me what happens ultimately and honestly constantly defending edits gets old and boring when there is no real challenge and life is passing by. I'd rather enjoy it than argue back and forth about stuff that essentially boils down to opinion of people who have zero credibility that I have seen in real life. Have any of you posted your diplomas anywhere lol? Really I would expect much more substance in your rebuttals (which would of course take optical phenomena caused by different shaped structures on each side of connected spheres into account now wouldn't they? ;-) the concept is as old as the circle & square illusion) but hey it's whatever.. Y'all have fun now! I mean that too. Enjoy life! :-)

Lazord00d (talk) 05:02, 11 January 2015 (UTC)

To be blunt, that you have only been able (thus far) to find settings that make chemically incorrect results or only fed it chemically incorrect input is not our problem. Every molecular modelling package (even the heavy-weight quantum computing ones) and every attempt to do something blindly/automatically from a skeletal structure (such as PubMed or related indexing) can and often does give wrong (sometimes wildly wrong) structural results if the initial parameters are not correct--we've seen examples on wikipedia of tangled rings, atomic collisions, and bonds intersecting each other. I would tolerate a single/double 3D diagram and certainly value making something clearer, but not at the expense of amplifying other incorrect aspects. Readers have a funny habit of putting trust in what they read; I think it's a horrible choice to make something more incorrect (with no other aspect being made more correct to compensate) just to be more understandable (especially when what's being made "more understandable" is not correct in the first place). What matters on wiki is what's on-wiki and what's citeable (WP:V policy)--we can all read literature and you can choose to avoid continuing to be a victim of GIGO. DMacks (talk) 10:53, 11 January 2015 (UTC)

Note that Jmol has a feature for measuring atomic distances, so you can measure for yourself whether the C–C and C=C are actually equal lengths (and just displayed with optical illusions). There's some science: I made an observation about your results, you proposed an alternate hypothesis to explain it; but you have the actual underlying data, so go prove it one way or another. Though why one would think that an image subject to optical illusions that suggest there are factual mistakes is better than one that doesn't is beyond me (especially if your claim is that this all is to better-illustrate it!). DMacks (talk) 10:59, 11 January 2015 (UTC)

Ahh there you go! Substance. Congratulations you're the first. Yay for you! But I'm still not waving my white flag :-)...

My interest in uploading images in the first place was to try to standardize some of the hodgepodge that's out there in terms of molecular visualization, so I thought about what variation would be the most beneficial to the most users and this is what I ended up with.. pretty much zero% of users will have thought about this as much as you or I have which is the reason I ended up with that result not to muddy the waters. If anything they're muddied by the randomness of the models that currently exist IMO. I have a feeling that a lot of them are inaccurate in far worse ways than mine with their double-bonds showing (oh myyyy).. this isn't a Chemistry textbook, it's an Encyclopedia. There is a difference in scope..

Lazord00d (talk) 11:31, 11 January 2015 (UTC)

Water intoxication

At Wikipedia:Articles for deletion/Sasha Rodriguez, about an article which reports several cases of death from water intoxication after consuming MDMA, I have proposed that information about that subject be merged to this article under "Adverse effects". The sourcing at that article is not satisfactory, but a scan of Google Scholar suggests that adequate sourcing can be found. Any input to that AfD is welcome, as is any comment here about whether such a merge would be appropriate. --MelanieN (talk) 23:03, 18 January 2015 (UTC)

Hyponatremia is discussed under Adverse effects. I don't think we'd need any sources from that article, particularly since they would need to comply with MEDRS for inclusion here. I would say just delete it; a merge is probably not necessary. Sizeofint (talk) 20:00, 19 January 2015 (UTC)

It's true that "life threatening hyponatremia" is mentioned in the article. That doesn't convey much to the casual reader. I was thinking it might be important to add that death can occur and has occurred under these circumstances. I don't see any mention of death, in plain English, in the article; people reading this article might need it stated a little more clearly that you can die from this course of action. Of course the references would have to meet MEDRS (which the ones in the AfD article don't, so you're right, merge is not an appropriate suggestion), but there are articles about this in the literature. Naturally I would propose any such addition and references here before adding anything to the article. --MelanieN (talk) 21:08, 19 January 2015 (UTC)

I don't think anyone would be opposed if you want to clarify or expand on water intoxication here. Sizeofint (talk) 01:24, 20 January 2015 (UTC)

Edits of January 29, 2015

@Sizeofint: I've not reverted you because I don't want to get into that mode, but I don't think we really have a reliable source yet for the idea that the DEA investigated MDMA use and never caught wind of its therapeutic use, which I think is a pretty extraordinary claim. The first reference is at least partly self-published, which flushes it immediately per WP:RS. The second is a legitimate publication, but what is says is "some guy in the DEA said they didn't know" which really does not support anything, as one can always find "some guy" willing to attest to just about anything. I don't mind the "DEA was surprised by the level of opposition", but the "DEA had no clue" part really just seems weak to me and in need of a stronger source if we are going to include it here. thanks Formerly 98 (talk) 00:24, 1 February 2015 (UTC)

@Formerly 98: I understand your concerns. I've reviewed the sources that claim the DEA was unaware of the therapeutic use of MDMA in 1984. All eventually link back to a Newsweek article published in April 1985 in which the DEA pharmacologist makes his statement. I have changed the text so it indicates the information originates from this single pharmacologist. Thanks for taking time to discuss. Sizeofint (talk) 03:08, 1 February 2015 (UTC)

Primary source usage

The paragraph I added the primary source to already has two primary sources citing neurotoxic effects; I do not understand why a primary source citing the cause of neurotoxicity would not be relevant. If secondary sources must be used, then the whole section should be deleted. This rule should either apply across the board or not. Please review WP:MEDRS; secondary sources are not a requirement. — Preceding unsigned comment added by Morrowfolk (talk • contribs) 00:47, 13 February 2015 (UTC)

@Morrowfolk: The second paragraph of WP:MEDRS states: " Primary sources should generally not be used for medical content. [Bolding in original]. Many such sources represent unreliable information that has not been vetted in review articles, or present preliminary information that may not bear out when tested in clinical trials."

Further down this message is repeated. "Primary sources should generally not be used for health related content, because the primary biomedical literature is exploratory and not reliable - any given primary source may be contradicted by another, and the Wikipedia community relies on the guidance of expert reviews, and statements of major medical and scientific bodies, to provide guidance on any given issue."

If there are other statements in the paragraph that are supported solely by primary sources, I will fully support their removal. Formerly 98 (talk) 01:34, 13 February 2015 (UTC)

Formerly 98 (talk) 01:34, 13 February 2015 (UTC)

I forgot to sign my last post, my apologies. Anyway, I am referring to this quote:

"If the conclusions of the research are worth mentioning (for instance, publication of a large, randomized clinical trial with surprising results), they should be described as being from a single study, for example:

"A large, NIH-funded study published in 2010 found that selenium and Vitamin E supplements increased the risk of prostate cancer; it was thought they would prevent prostate cancer." (citing PMID 20924966)

After enough time has passed for a review in the area to be published, the review should be cited in preference to the primary study. Using a secondary source often allows the fact to be stated with greater reliability:

"Supplemental Vitamin E and selenium increase the risk of prostate cancer." (citing PMID 23552052)

If no review on the subject is published in a reasonable amount of time, then the content and primary source should be removed."

The citation in question was published in a journal that does not promote an agenda, and certainly had surprising results. However, it is from 2011 and does not have a review that I can find. There are a few comments, but that is essentially it. I do not see refutation of the data... Is three years too long? "Reasonable amount of time" is vague.

Thank you for the clarification of your views; I was initially very annoyed because many users post rules as a means of maintaing a certain view in an article, but you make it clear that you are simply attempting to improve the quality of medical articles. Morrowfolk (talk) 18:33, 13 February 2015 (UTC)

The main reason we're not going to include that is because it refutes what the reviews conclude, where most of those neurotoxicity reviews are 2-3 years more current than that primary source. Seppi333 (Insert 2¢ | Maintained) 21:06, 13 February 2015 (UTC)

Edit: btw, there are a couple newer primary sources like PMID 23194825, PMID 24101030, and PMID 24177245 which suggest MDMA also produces dopamine neurotoxicity through its metabolites. We don't include these either simply because they're primary sources. Seppi333 (Insert 2¢ | Maintained) 21:10, 13 February 2015 (UTC)

Molly gets two definitions?

In the text it both says molly means the pure form and other things - this is directly in contradiction with each other. It can't mean the unadulterated form if it also means other drugs! "The UK term "Mandy" and the US term "Molly" colloquially refer to MDMA in a crystalline powder form that is relatively free of adulterants.[5][6] "Molly" can sometimes also refer to the related drugs methylone, MDPV, mephedrone or any other of the pharmacological group of compounds commonly known as bath salts.[12]" This pair of sentences would probably be better to say that the name was given to one but has expanded on the street to mean any of these such as:"The UK term "Mandy" and the US term "Molly" colloquially refer to MDMA[5][6], however "Molly" can sometimes also refer to the related drugs methylone, MDPV, mephedrone or even any other of the pharmacological group of compounds commonly known as bath salts.[12]" ...which then wouldn't contradict itself by saying it was the colloquially pure when it can mean all the others which are colloquially not pure. A statement that the street form is usually a tablet or encapsulated powder probably should be in a different sentence not contradicting itself. 76.21.107.77 (talk) 19:55, 23 February 2015 (UTC)

A couple of points here:

• The first statement says "colloquially", which implies that it is vernacular and/or slang, and therefore not always or even generally accepted;
• The second statement says "'Molly' can sometimes refer to (object)"; the word "can" is not the same as the word "must", which implies that it doesn't always refer to (object).
• (edit) What, pray tell, does "colloquially pure" mean?

This is basic English grammar, and I'm tired of this silly argument over "MDMA" vs "Molly". "MDMA" clearly and unambiguously describes the chemical which is the subject of this article. Street names are relevant to the discussion but ultimately a distraction. If you don't like it, you're free to change it, but please don't do it from an anonymous IP. Simishag (talk) 22:42, 23 February 2015 (UTC)

INACCURACIES

MANDY was ENGLISH name for a prescribed drug with the TRADE NAME MANDRAX ( a sedative containing METHAQUALONE & DIPHENHYDRAMINE HYDROCHLORIDE ). The GERMAN ARMY was EXPERIMENTING with MDMA in 1934 . — Preceding unsigned comment added by 134.2.64.114 (talk) 18:46, 2 March 2015 (UTC)

I can tell you that the sources I have read do not mention experimentations with MDMA in 1934. It is possible they were experimenting with MDA however. Sizeofint (talk) 18:51, 2 March 2015 (UTC)

I am not sure about Mandy as a slang term, however Urban Dictionary lists powdered MDMA as the most popular definition of Mandy. Granted, UD is not a reliable source but it indicates the term is plausible. Sizeofint (talk) 18:57, 2 March 2015 (UTC)

A quick Google News search turns up numerous references that indicate "Mandy" is indeed a slang term for MDMA, particularly in the UK. -- Ed (Edgar181) 19:05, 2 March 2015 (UTC)

Semi-protected edit request on 8 March 2015

Addiction and dependence glossary
addiction – a biopsychosocial disorder characterized by persistent use of drugs (including alcohol) despite substantial harm and adverse consequences addictive drug – psychoactive substances that with repeated use are associated with significantly higher rates of substance use disorders, due in large part to the drug's effect on brain reward systems dependence – an adaptive state associated with a withdrawal syndrome upon cessation of repeated exposure to a stimulus (e.g., drug intake) drug sensitization or reverse tolerance – the escalating effect of a drug resulting from repeated administration at a given dose drug withdrawal – symptoms that occur upon cessation of repeated drug use physical dependence – dependence that involves persistent physical–somatic withdrawal symptoms (e.g., fatigue and delirium tremens) psychological dependence – dependence socially seen as being extremely mild compared to physical dependence (e.g., with enough willpower it could be overcome) reinforcing stimuli – stimuli that increase the probability of repeating behaviors paired with them rewarding stimuli – stimuli that the brain interprets as intrinsically positive and desirable or as something to approach sensitization – an amplified response to a stimulus resulting from repeated exposure to it substance use disorder – a condition in which the use of substances leads to clinically and functionally significant impairment or distress tolerance – the diminishing effect of a drug resulting from repeated administration at a given dose

Please change "has potential adverse effects, such as neurotoxicity and addiction" to "has potential adverse effects, such as neurotoxicity and transient addiction" as that is what the source claims.

Although these findings may not apply to all groups of ecstasy users, they suggest that ecstasy abuse and dependence may be transient phenomena in many, if not most, instances. - Meyer, J. in 3,4-methylenedioxymethamphetamine (MDMA): current perspectives

Boddika (talk) 15:28, 8 March 2015 (UTC)

Dependence is not addiction. Seppi333 (Insert 2¢ | Maintained) 22:43, 8 March 2015 (UTC)

But isn't dependence required for addiction? Either way, seems like the main issue is the lack of the word "transient", which was not addressed. SaltyRide (talk) 16:24, 15 March 2015 (UTC)

Not done: please establish a consensus for this alteration before using the {{edit semi-protected}} template. — {{U|Technical 13}} (e • t • c) 22:06, 15 March 2015 (UTC)

Dependence and addiction are 2 entirely different concepts. The ref makes no statement at all about addiction. Seppi333 (Insert 2¢ | Maintained) 23:26, 15 March 2015 (UTC)

References

Lack of appropriate reference for MDA as "direct neurotoxin"

I noted a citation was needed for the claim that MDA is a "direct neurotoxin". The reference added by Seppi333, actually a compendium of abstract-style summaries of primary literature, does not seem to support the claim. The first appearance of the word MDA claims to be a peer reviewed citation, but it's actually an unreviewed government website and the word "MDA" appears to be a typo:

"Research shows that MDA destroys serotonin-producing neurons in the brain, which play a direct role in regulating aggression, mood, sexual activity, sleep, and sensitivity to pain. It is probably this action on the serotonin system that gives MDMA its purported properties of heightened sexual experience, tranquility, and convivality. [National Institute on Drug Abuse (NIDA) Infofax on ECSTASY. Available from http://www.nida.nih.gov/Infofax/ecstasy.html on Wednesday, May 17,2000] **PEER REVIEWED* "

This is obviously not peer reviewed. The linking of MDA in the first sentence with "this action" in the second makes it clear that MDA is a typo and that they meant to write MDMA. Moreover, the sentence about MDA does not appear on the website, as far as I can tell. I suggest that Toxnet be deprecated in favor of more reliable refernces. The vast majority of the papers it mentions seem to be about MDMA and many describe NIH-funded studies where volunteers were given MDMA. The only other mention relevant to MDA toxicity I see seems to state the opposite of the original claim:

"Direct injection of either 3,4-(+/-)-methylenedioxymethamphetamine (MDMA) or 3,4-(+/-)-methylenedioxyamphetamine (MDA) into the brain fails to reproduce the serotonergic neurotoxicity seen following peripheral administration."

I propose adding in the citation needed tag or removing the sentence, which has only peripheral relevance since it isn't about MDMA. 173.228.54.200 (talk) 04:56, 26 November 2014 (UTC)

I corrected the issue with species earlier which had been incorrectly stated. The current version is in accordance with the source, so I'm not going to revise this further. Seppi333 (Insert 2¢ | Maintained) 05:10, 26 November 2014 (UTC)

I'm sorry, can you clairify what you mean by "the issue with species"? I have pointed out that the references you gave do not support the claim the MDA is a neurotoxin. Do you believe they do? 173.228.54.200 (talk) 05:16, 26 November 2014 (UTC)

https://en.wikipedia.org/w/index.php?title=MDMA&diff=635435983&oldid=635414760 - notice the timestamp relative to your post. I'm not sure what the issue with the current revision is. Seppi333 (Insert 2¢ | Maintained) 05:22, 26 November 2014 (UTC)

Actually, given that this is nonhuman animals, I'm just going to delete the clause. Neurotoxicity in animals doesn't necessarily reflect upon humans by any means. Seppi333 (Insert 2¢ | Maintained) 05:37, 26 November 2014 (UTC)

The issue was that the reference does not support any neurotoxicity from MDA, only MDMA. And I have a secondary concern that the reference is unreliable since it claims un-reviewed goverment websites were peer reviwed and it has important typos. I suggest Toxnet be depricated as a reference. 173.228.54.200 (talk) 05:38, 26 November 2014 (UTC)

Toxnet satisfies WP:MEDRS. Trying to argue this point is going to get you nowhere. Seppi333 (Insert 2¢ | Maintained) 05:40, 26 November 2014 (UTC)

Interesting. Can you explain how Toxnet fits that WP? It isn't clear to me that it does. And it appears to me that its value is questionable. The first thing you/they cited mentioned the wrong drug through a typo and claimed an unreviewed web article was peer-reviewed. How can this be alleged to be reliable? And there seems to be no recourse for correcting it: In the FAQ, Toxnet says that non-Pubmed parts cannot be corrected because they are not produced by the NLM. Regards, 173.228.54.200 (talk) 05:51, 26 November 2014 (UTC)

I'm not going to argue over this. Ask about the source here if you actually want to push the issue: WT:MED. Seppi333 (Insert 2¢ | Maintained) 05:56, 26 November 2014 (UTC)

Done. Thanks for the pointer. 173.228.54.200 (talk) 06:05, 26 November 2014 (UTC)

I agree that Toxnet is not a reliable source per WP. It obscures the actual sources. SaltyRide (talk) 04:54, 11 March 2015 (UTC)