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|from = Talk:MDMA/Effects of MDMA on the human body

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==Class==

What should we put as the class of this drug?

I propose [[psychoactive drug]]. [[User:Sizeofint]] proposes [[Empathogen-entactogen]]. Others thoughts? [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 22:25, 17 December 2016 (UTC)

:Why? "Psychoactive drug" isn't a [[drug class]]. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 05:49, 18 December 2016 (UTC)

::This book lists it as a "hallucinogen"[https://books.google.ca/books?id=-kNvCgAAQBAJ&pg=PA290] would be happy with that aswell. The DEA does not recognize "entactogen" [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 07:27, 18 December 2016 (UTC)

:::Causing hallucinations isn't really a primary effect of MDMA though. Even in this article we describe the hallucinatory effects as "mild". The primary effects of MDMA are on mood - not the modification of external stimuli. In that respect, it is more similar to an anti-depressant than a hallucinogen. Even "stimulant" would be a more accurate classification, though that also doesn't completely capture it. I'll look at a few reviews and see how they are classifying MDMA. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 07:42, 18 December 2016 (UTC)

:::Even the authors of that book admit the term "hallucinogen" is misleading on page 289. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 07:49, 18 December 2016 (UTC)

::::{{tq|In the mid-1980s, based on the structure–activity relationships of MDMA-like molecules, Nichols (1986) proposed that the psychosocial effects of MDMA represented a novel pharmacological class, which he named “'''entactogens'''” to capture its apparently unique sensory and emotional effects. Data from rodent drug-discrimination paradigms (reviewed in Glennon, 1999; Nichols and Oberlender, 1989) suggested that MDMA was clearly '''distinguishable from hallucinogens''', but shared many pharmacological, discriminative, and behavioral effects with prototypic amphetamine-like '''stimulants'''. Finally, in the 1990s, researchers began to conduct controlled studies to measure the psychosocial effects of MDMA in humans and to compare these to the effects of other stimulants'''.}}<ref>{{cite journal|last1=Bershad|first1=A. K.|last2=Miller|first2=M. A.|last3=Baggott|first3=M. J.|last4=de Wit|first4=H.|title=The effects of MDMA on socio-emotional processing: Does MDMA differ from other stimulants?|journal=Journal of Psychopharmacology|date=25 August 2016|volume=30|issue=12|pages=1248–1258|doi=10.1177/0269881116663120}}</ref>

::::{{tq|MDMA has a '''stimulant''', '''hallucinogenic''' effect, and is also known to enhance mental factors such as energy, empathy and euphoria (12).}}<ref>{{cite journal|last1=Bora|first1=F|last2=Yılmaz|first2=F|last3=Bora|first3=T|title=Ecstasy (MDMA) and its effects on kidneys and their treatment: a review.|journal=Iranian journal of basic medical sciences|date=November 2016|volume=19|issue=11|pages=1151-1158|pmid=27917269}}</ref>

::::{{tq|Moreover, people can experience '''entactogenic''' effects and feel extremely connected with others and some even have '''mild hallucinations'''}}<ref>{{cite journal|last1=Vegting|first1=Yosta|last2=Reneman|first2=Liesbeth|last3=Booij|first3=Jan|title=The effects of ecstasy on neurotransmitter systems: a review on the findings of molecular imaging studies|journal=Psychopharmacology|date=28 August 2016|volume=233|issue=19-20|pages=3473–3501|doi=10.1007/s00213-016-4396-5}}</ref>

::::{{tq| MDMA has been called an '''entactogen''', meaning literally “to produce touching within”, referring to its tendency to enhance inner awareness and '''distinguishing it from classic psychedelic drugs''' such as psilocybin}}<ref>{{cite journal|last1=Mithoefer|first1=Michael C|last2=Grob|first2=Charles S|last3=Brewerton|first3=Timothy D|title=Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA|journal=The Lancet Psychiatry|date=May 2016|volume=3|issue=5|pages=481–488|doi=10.1016/S2215-0366(15)00576-3}}</ref>

::::{{tq|Because of this serotonergic component, MDMA exhibits some mental effects that '''differ qualitatively from other amphetamine-type stimulants''' (Schmid et al., 2014&nbsp;and&nbsp;Schmid et al., 2015) and for this reason MDMA has been classified as an “'''entactogen'''”.}}<ref>{{cite journal|last1=Mueller|first1=F.|last2=Lenz|first2=C.|last3=Steiner|first3=M.|last4=Dolder|first4=P.C.|last5=Walter|first5=M.|last6=Lang|first6=U.E.|last7=Liechti|first7=M.E.|last8=Borgwardt|first8=S.|title=Neuroimaging in moderate MDMA use: A systematic review|journal=Neuroscience & Biobehavioral Reviews|date=March 2016|volume=62|pages=21–34|doi=10.1016/j.neubiorev.2015.12.010}}</ref>

::::{{tq|Whereas phenethylamines without ring substitution usually behave as stimulants, ring substitution (as in MDMA) leads to a modification in the pharmacological properties. Ingestion of MDMA causes euphoria, increased sensory awareness and '''mild central stimulation'''. It is '''less hallucinogenic''' than its lower homologue, methylenedioxyamphetamine (MDA). The terms '''empathogenic and entactogenic''' have been coined to describe the socialising effects of MDMA.}}<ref>{{cite web|title=Methylenedioxymethamphetamine (MDMA or 'Ecstasy')&nbsp;drug profile|url=http://www.emcdda.europa.eu/publications/drug-profiles/mdma|publisher=European Monitoring Centre for Drugs and Drug Addiction|accessdate=18 December 2016}}</ref>

:::::A couple of books: {{tq|Thought to be relatively save, in the mid-1970s it was proposed as an adjuvant to psychotherapy by Leo Zeff and other experimental psychiatrists who touted its ability to increase patient self-esteem, empathy and nondefensiveness and to facilitate therapeutic communication; thus its original classification as and "'''empathogen'''", though the term "'''entactogen'''" is now preferred.}}[https://books.google.com/books?id=MUYfAQAAQBAJ&pg=PA299&dq=mdma+entactogen&hl=en&sa=X&ved=0ahUKEwit9ryYsP3QAhXKKyYKHQEVBy0Q6AEIQDAG#v=onepage&q=mdma%20entactogen&f=false] {{tq|Although '''entactogens''' and '''stimulants''' display similar stereoselectivity, when tested within their respective classes, the ''R'' isomers of MDA, MDMA, and MBDB substitute for MDMA and (+)-MBDB but not for (+)-amphetamine.}} [https://books.google.com/books?id=e87cBwAAQBAJ&pg=PA125&dq=mdma+entactogen&hl=en&sa=X&ved=0ahUKEwit9ryYsP3QAhXKKyYKHQEVBy0Q6AEIHTAA#v=onepage&q=mdma%20entactogen&f=false]

:::::Bolding mine. This is what I found on the first page of pubmed index reviews (at least from the ones I can access). The book results are admittedly more biased because I searched 'MDMA entactogen'. Most of the articles here emphasize how MDMA is different from typical stimulants and hallucinogens. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 08:42, 18 December 2016 (UTC)

{{outdent}}

This says the term "entactogens" is not recognized by the DEA.[https://books.google.ca/books?id=OWFiVaDZnkQC&pg=PA126] "Some authors proposed that MDMA represented a novel class of drugs, the entactogens that were not hallucinogenic. However, the DEA did not accept this new classification" [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 23:13, 18 December 2016 (UTC)

::This book calls it a "stimulant" and a "hallucinogen"[https://books.google.ca/books?id=ubG51n2NgfwC&pg=PA128] [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 23:22, 18 December 2016 (UTC)

::::This paper calls it a stimulant and talks about how Nichols '''proposed''' the novel class "entactogens". I am not seeing that this is an officially accepted drug class. [http://journals.sagepub.com/doi/full/10.1177/0269881116663120] [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 23:25, 18 December 2016 (UTC)

:::::The DEA is '''a''' view - a potentially heavy weight one to be sure - but not the arbiter of what is and is not accepted classification for drugs. If the consensus in the scientific literature is that this is a valid classification - and that I think is what my initial survey of the latest reviews in PubMed suggest - then that is what we should go with regardless of the DEA's stance. To my knowledge, no scientist has the power to say, "this is now officially a drug class" so in that sense all drug classes are 'proposed'. It simply becomes accepted over time that this is indeed a valid drug classification. We can see this over at [[opioid]]. There isn't a single definition of opioid, only a set of 'proposed' definitions which are used until some more refined usage takes precedence. Notably, none of the reviews I read here disputed this classification. If they did dispute anything, it was the simple classification of MDMA with other hallucinogens and stimulants. Also, not all the sources I quote above use this 'proposed' modifier. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 00:22, 19 December 2016 (UTC)

::::::Additional sources:

::::::Not MEDRS but shows traction of the term - {{tq|MDMA is the prototypical empathogen and entactogen drug}}<ref>{{cite web|title=Stimulants: Background, Drug Enforcement Agency Classification System, Types of Stimulants|url=http://emedicine.medscape.com/article/289007-overview#a3|publisher=MedScape|accessdate=19 December 2016|date=10 June 2016}}</ref>

::::::Government agency - {{tq|Drug Class: Mild CNS stimulant, empathogen, entactogen, mild hallucinogen and psychedelic, appetite suppressant.}}<ref>{{cite web|title=Drugs and Human Performance FACT SHEETS - Methylenedioxymethamphetamine (MDMA, Ecstasy)|url=https://one.nhtsa.gov/people/injury/research/job185drugs/methylenedioxymethamphetamine.htm|publisher=National Highway Traffic Safety Administration|accessdate=19 December 2016|date=2001}}</ref>

::::::{{tq| Members of the entactogen class of psychostimulants (drugs that produce an “open mind state” including feelings of interpersonal closeness, intimacy and empathy) have been less frequently studied in self-administration models. The prototypical entactogen 3,4-methylenedioxymethamphetamine (MDMA; “Ecstasy”) supports self-administration but not with the same consistency nor with the same efficacy as structurally related drugs amphetamine or methamphetamine.}}<ref>{{cite journal|last1=Aarde|first1=Shawn|last2=Taffe|first2=Michael|title=Predicting the Abuse Liability of Entactogen-Class, New and Emerging Psychoactive Substances via Preclinical Models of Drug Self-administration|journal=Current Topics in Behavioral Neurosciences|date=2 December 2016|pages=1-20|doi=10.1007/7854_2016_54|url=http://link.springer.com/chapter/10.1007/7854_2016_54}}</ref>

* FWIW: the {{para|class}} parameter takes & shows any text (unformatted). So one could use a list of classnames, or add a description/reference. I only hope it won't be too expanded, in an infobox. -[[User:DePiep|DePiep]] ([[User talk:DePiep|talk]]) 11:50, 19 December 2016 (UTC)

:::How about "stimulant (entactogen)"? [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 17:46, 19 December 2016 (UTC)

::::{{Ping|Doc James|Sizeofint}} Based upon the unique psychoactive effects of MDMA relative to other substituted amphetamines that lack a [[Methylenedioxy|methylenedioxy ring]], I think "[[Empathogen–entactogen]]" would be the most appropriate drug class for this compound. I've seen MDMA (as well as other methylenedioxy- derivatives of amphetamine) classified differently than amphetamine and methamphetamine in almost every paper that I've read on the class of substituted amphetamines. In most cases, MDMA and related derivatives were referred to entactogens and/or empathogens, which is in agreement with the references which Sizeofint provided. I imagine that the DEA doesn't "recognize" these two terms as drug classes because MDMA is the parent compound for all compounds in this class, none of them are licit substances, and none of them have any current medical uses. In any event, the DEA isn't an organization that is involved in the classification of drugs or other biologically active substances.

::::The two most common classification systems for drugs are the [[Anatomical Therapeutic Chemical Classification System]] (which assigns [[ATC code]]s) and [[Systematized Nomenclature of Medicine]]. MDMA has not been assigned a drug class in either of these systems. In some cases, these classification systems assign compounds to drug classes with rather technical names; for example, amphetamine's ATC code (N06BA01) assigns amphetamine to the class of "[[ATC_code_N06#N06B_Psychostimulants.2C_agents_used_for_ADHD_and_nootropics|centrally acting sympathomimetics]]" (note: this class is a subcategory of [[psychoanaleptics]] and "[[psychostimulants]], agents used for ADHD, and [[nootropics]]"), which essentially means "drugs which activate the sympathetic nervous system by stimulating the central nervous system". In lieu of this technical classification, I used "{{abbr|CNS|central nervous system}} [[stimulant]]" in amphetamine's drugbox, since it's almost the same classification.

::::I don't believe that listing "[[hallucinogen]]" alone is an accurate classification for MDMA or any other substituted amphetamine for that matter. "CNS stimulant" describes some of MDMA's drug effects, but does not encompass the pro-social, empathy-promoting (i.e., [[empathogenic]]) effects for which it is often used recreationally.

::::I think an adequate compromise would be to list "[[Empathogen–entactogen]]", "{{abbr|CNS|central nervous system}} [[stimulant]]", and possibly "[[Euphoriant]]" and/or "mild [[hallucinogen]]" as drug classes in the drugbox class parameter. Listing the first 2, and possibly one or both of the other classes as well, should adequately cover its classification. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 18:57, 19 December 2016 (UTC)

::::::Maybe leave it blank than if it is not categorized by either ATC code or SNM [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 19:00, 19 December 2016 (UTC)

*I saw the note at [[WT:PHARM]], and it's an interesting question. In a sense, it's really just "miscellaneous". I'd say the most precise description would be "[[euphoriant]], [[empathogen–entactogen]]". I edit conflicted with Seppi333, and this suggestion is similar to his. --[[User:Tryptofish|Tryptofish]] ([[User talk:Tryptofish|talk]]) 19:06, 19 December 2016 (UTC)

:::::::These proposals seem reasonable to me. Simply saying MDMA is a stimulant or hallucinogen is, I think, misleading. That MDMA isn't present in a formal classification system is likely just due to its lack of medical indications. I don't think not having an ATC code is a persuasive reason to ignore how reliable medical/scientific sources are classifying it. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 02:54, 20 December 2016 (UTC)

===Section references===

{{talk reflist|section}}

== Addictiveness ==

{{U|Petergstrom}}, is there a newer source for the claim of non-addictiveness? 1999 is rather old. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 03:05, 8 January 2017 (UTC)

::Agree

::*{{cite journal|last1=Pentney|first1=Alana|title=An Exploration of the History and Controversies Surrounding MDMA and MDA|journal=Journal of Psychoactive Drugs|date=Sept 2001|volume=33|issue=3|pages=213-221|url=http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.688.6834&rep=rep1&type=pdf}}

::*{{cite journal|last1=Jansen|first1=K. L.|title=Ecstasy (MDMA) dependence|journal=Drug and Alcohol Dependence|date=7 January 1999|volume=53|issue=2|pages=121–124|url=https://www.ncbi.nlm.nih.gov/pubmed/10080038|issn=0376-8716}}

::This source says "may not induce classical manifestations of physical dependence"[https://books.google.ca/books?id=OWFiVaDZnkQC&pg=PA139#v=onepage&q&f=false]

::Which is not the same to as saying no risk of addiction. [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 07:57, 8 January 2017 (UTC)

Ref says "MDMA users may encounter problems similar to those experienced by amphetamine and cocaine users, '''including addiction'''. MDMA damages brain serotonin neurons. Serotonin is thought to play a role in regulating mood, memory, sleep, and appetite. Research indicates heavy MDMA may cause persistent memory problems in humans; however, a 2011 study has reported limited cognitive decline in users of MDMA.1"[https://www.drugs.com/illicit/mdma.html]

NIH says "Research results vary on whether MDMA is addictive. Experiments have shown that animals will self-administer MDMA—an important indicator of a drug’s abuse potential—although to a lesser degree than some other drugs such as cocaine."[https://www.drugabuse.gov/publications/drugfacts/mdma-ecstasymolly] [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 08:04, 8 January 2017 (UTC)

"With no reports of subjects who take large amounts of MDMA for long periods of time (Peroutka l 990a), indi­ cating that the drug is not addictive, "

"It has been shown that MDMA is not addictive in humans (Beck & Rosenbaum 1 994; Peroutka 1 990a; Riedlinger 1 985),"

[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 08:35, 8 January 2017 (UTC)

::All those sources are old and the never sources say something different. [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 09:13, 8 January 2017 (UTC)

I would disagree, saying that the sources are totally fine despite being over a decade old, but it smells to me like the consensus is on the other side so I guess thats that #Ripmemes[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 09:19, 8 January 2017 (UTC)

:I think both statements should be cited, with the context. The NIH statement is more recent, ''but'' it refers to animals and that animals self-administer MDMA does not by default entail that humans will as well (also noted [[WP:MEDANIMAL]]). The older statements refer to humans but are, well, older, and may have been superseded by later research. On their own, none out-[[WP:WEIGHT]]-s the other. [[User:Jo-Jo Eumerus|Jo-Jo Eumerus]] ([[User talk:Jo-Jo Eumerus|talk]], [[Special:CentralAuth/Jo-Jo Eumerus|contributions]]) 09:43, 8 January 2017 (UTC)

We have lots of other good sources that also comment on the addiction of MDMA include "[https://books.google.ca/books?id=P9piCAAAQBAJ&pg=PA960 There are no specific pharmacologic treatments for MDMA addiction]" 2015 Nelson Textbook of Peds [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 10:04, 8 January 2017 (UTC)

::We have a 2010 review that says "[https://www.ncbi.nlm.nih.gov/pubmed/20017726 MDMA also modulates the activity of the dynorphinergic and enkephalinergic systems in several brain structures related to addiction, as it has been shown for other psychostimulants."] [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 10:16, 8 January 2017 (UTC)

This 2013 review is even clearer "[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931692/ Users often consider ecstasy to lack the potential for dependence or addiction, but this is not the case.]" [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 10:26, 8 January 2017 (UTC)

:per [https://www.ncbi.nlm.nih.gov/pubmed/?term=3%2C4-methylenedioxymethamphetamine+(MDMA)%3A+current+perspectives]it ''is'' a review and quite clear agree w/ Doc James--[[User:Ozzie10aaaa|Ozzie10aaaa]] ([[User talk:Ozzie10aaaa|talk]]) 11:44, 8 January 2017 (UTC)

I don't have access to that, but to me it smells primary. So right now we have two old sources saying it is not addictive and one new animal source and a new primary source that says it is. And we have this: http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60464-4/abstract source from the lancet that suggests its psychological dependence potential(addictive potential) is lower than cannabis.....Looks pretty clear cut, we can't say wether to not it is addictive. Better to keep it at None to moderate [[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 10:36, 8 January 2017 (UTC)

::Ah seriously? It is avaliable openly from PMC[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931692/] and pubmed calls it a review article. [[User:Doc James|<span style="color:#0000f1">'''Doc James'''</span>]] ([[User talk:Doc James|talk]] · [[Special:Contributions/Doc James|contribs]] · [[Special:EmailUser/Doc James|email]]) 11:53, 8 January 2017 (UTC)

:::{{U|Petergstrom}} — making up facts is not a good way to go. You have access and it is marked as a review.... [[User:CFCF|<span style="color:#014225;font-family: Copperplate Gothic Bold;text-shadow:0px -1px 0px #014225;">Carl Fredrik</span>]]<span style="font-size: .90em;">[[User talk:CFCF| 💌]] [[Special:EmailUser/CFCF|📧]]</span> 11:58, 8 January 2017 (UTC)

Woah carl thats hostile. I googled the title and the sites i visited recquired purchase. I read the article on pubmed and it mentions dependence but i cant find it explicitly stating addiction. I still think we should list as none to moderate[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 13:03, 8 January 2017 (UTC)

:Primary sources and dated sources are unacceptable. We stick to recent reviews. [[User:QuackGuru|<font color="vermillion">'''QuackGuru'''</font>]] ([[User talk:QuackGuru|<font color="burntorange">talk</font>]]) 17:45, 8 January 2017 (UTC)

*[[User:Petergstrom]] Pubmed abstracts include a classification. Click on this link for the 2013 review discussed above: PMID 24648791. Scroll down to where it says "Publication types". click the double downward arrowheads to the right, to reveal what is in the field. You will see it says "review" there. The abstract at pubmed also clearly displays links to the free version of the article, which anyone can reach by clicking the hyperlink where it says in bold and brown font "Free PMC Article", which is [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931692/ here].

:You have now had these extremely basic things about working with medical references explained to you

:If you ever write things like this again (and I am recording the diffs): [https://en.wikipedia.org/w/index.php?title=Talk%3AMDMA&type=revision&diff=758939056&oldid=758938144 diff] where you wrote: {{tq|I don't have access to that, but to me it smells primary.}}. [https://en.wikipedia.org/w/index.php?title=Talk:MDMA&diff=next&oldid=758946847 diff] {{tq|I googled the title and the sites i visited recquired purchase}} you will not be editing about health much longer in WP. [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 04:26, 11 January 2017 (UTC)

[[User:Jytdog]], woah, that that edit did not intent to discredit the source... I clicked on something and it asked for money, so I said I had no access. Someone could have just said, no you have access, its a review...and someone did, and I accepted it.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 04:44, 11 January 2017 (UTC)

:No. The diffs say what they say {{tq|I don't have access to that, but to me it smells primary.}} when the pubmed abstract is free and obviously classifies the ref as a review. You demonstrated pure incompetence or tendetiousness and in the context of an edit war, and none of that is acceptable. I will not continue this discussion. I have warned you to behave and edit better and that is done. [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 04:50, 11 January 2017 (UTC)

=== Dated sources? ===

:The discussion is still underway. I don't see consensus for [https://en.wikipedia.org/w/index.php?title=MDMA&type=revision&diff=759028883&oldid=758996859 this]. Is there a good reason to use dated sources? [[User:QuackGuru|<font color="vermillion">'''QuackGuru'''</font>]] ([[User talk:QuackGuru|<font color="burntorange">talk</font>]]) 22:39, 8 January 2017 (UTC)

::{{ec}} {{U|Petergstrom}}, there have been loads of reviews published the last five years. I would think there should be some that include this content if it is still the scientific consensus. If they don't then it is highly possible new research has altered the consensus. We want this article to reflect current scientific opinion which might be different from the scientific opinion from eight or sixteen years ago. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 01:56, 9 January 2017 (UTC)

I don't own the book, but someone pointed out the source referenced [[WP:MEDANIMAL]], and the quotation for the book does not mention addiction at all. I think both statements should be cited as someone mentioned above.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 01:50, 9 January 2017 (UTC)

:Which statement? [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 01:58, 9 January 2017 (UTC)

:Updated the addiction liability with a newer source. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 02:25, 9 January 2017 (UTC)

::I don't see how changing

::{{tq|<nowiki>Impairments in multiple aspects of cognition, including memory, visual processing, and sleep have been noted in humans;<ref name=Current2013 /><ref name=Pharm2014 /><ref name="Abstinent MDMA fMRI review" /> the magnitude of these impairments is correlated with lifetime MDMA usage.<ref name=Current2013 /><ref name=Pharm2014 /><ref name="Abstinent MDMA fMRI review" /> Memory is impacted by ecstasy use, which is associated with impairments in several forms of memory.<ref name=Current2013 /><ref name=Pharm2014 /> </nowiki>}}

::to the following is an improvement.

::{{tq|However these findings have been inconsistent have have been of small significance,<ref>{{cite journal|last1=Laws|first1=Keith R.|last2=Kokkalis|first2=Joy|title=Ecstasy (MDMA) and memory function: a meta-analytic update|journal=Human Psychopharmacology|date=1 August 2007|volume=22|issue=6|pages=381–388|doi=10.1002/hup.857|url=https://www.ncbi.nlm.nih.gov/pubmed/17621368/|issn=0885-6222}}</ref><ref>{{cite journal|last1=Rogers|first1=G.|last2=Elston|first2=J.|last3=Garside|first3=R.|last4=Roome|first4=C.|last5=Taylor|first5=R.|last6=Younger|first6=P.|last7=Zawada|first7=A.|last8=Somerville|first8=M.|title=The harmful health effects of recreational ecstasy: a systematic review of observational evidence|journal=Health Technology Assessment (Winchester, England)|date=1 January 2009|volume=13|issue=6|pages=iii–iv, ix-xii, 1-315|doi=10.3310/hta13050|url=https://www.ncbi.nlm.nih.gov/pubmed/19195429/|issn=2046-4924}}</ref><ref>{{cite journal|last1=Gouzoulis-Mayfrank|first1=E.|last2=Daumann|first2=J.|title=Neurotoxicity of methylenedioxyamphetamines (MDMA; ecstasy) in humans: how strong is the evidence for persistent brain damage?|journal=Addiction (Abingdon, England)|date=1 March 2006|volume=101|issue=3|pages=348–361|doi=10.1111/j.1360-0443.2006.01314.x|url=https://www.ncbi.nlm.nih.gov/pubmed/16499508/|issn=0965-2140}}</ref> creating controversy surrounding the causal role of MDMA in long term cognitive impairment.<ref>{{cite journal|last1=Lyvers|first1=Michael|title=Recreational ecstasy use and the neurotoxic potential of MDMA: current status of the controversy and methodological issues|journal=Drug and Alcohol Review|date=1 May 2006|volume=25|issue=3|pages=269–276|doi=10.1080/09595230600657758|url=https://www.ncbi.nlm.nih.gov/pubmed/16753651/|issn=0959-5236}}</ref>}}

::Assuming the text adequately summarizes the sources, the old version has references five to eight years more recent than this new text. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 02:53, 9 January 2017 (UTC)

::The article is slowing moving forward without the dated sources. Every 5 years we can do this again. [[User:QuackGuru|<font color="vermillion">'''QuackGuru'''</font>]] ([[User talk:QuackGuru|<font color="burntorange">talk</font>]]) 02:59, 9 January 2017 (UTC)

The addiction liability of MDMA is based upon this ref<ref name="NHM-MDMA" /> and the ratings of similar dopamine releasing agents on Wikipedia. I don't see a compelling reason to change this. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 03:03, 9 January 2017 (UTC)

:If the newer source is as good quality we should prefer it. The desired effects of MDMA are mainly serotonergic so I would expect the usage patterns to be somewhat different from other dopamine releasing agents. Different usage patterns could affect the addiction liability. Consequently, I don't think we can necessarily expect MDMA to have the same liability. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 03:18, 9 January 2017 (UTC)

:I'm fine with leaving it at moderate though since that seems an acceptable reading of the source. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 03:21, 9 January 2017 (UTC)

::{{U|Petergstrom}}, why are you using older sources to overwrite content from newer sources? If the newer sources mention the evidence is low quality, why don't you just cite them? Also, you're over [[WP:3RR]]. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 03:30, 9 January 2017 (UTC)

If i am over 3RR, so are you. Fine I will cite newer sources.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 03:33, 9 January 2017 (UTC)

:My count is I reverted twice, Quack another two times, and Seppi once. But in any case, thanks. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 03:36, 9 January 2017 (UTC)

:::ill watchlist this article--[[User:Ozzie10aaaa|Ozzie10aaaa]] ([[User talk:Ozzie10aaaa|talk]]) 12:00, 9 January 2017 (UTC)

:That's not enough to cite newer sources. We can expunge the older sources now rather than later. Is there a reason to use dated sources? [[User:QuackGuru|<font color="vermillion">'''QuackGuru'''</font>]] ([[User talk:QuackGuru|<font color="burntorange">talk</font>]]) 12:30, 9 January 2017 (UTC)

::If there is a newer source cited with them I think the old sources are harmless to keep. They'll eventually disappear by attrition. Actively hunting them down is more effort than it is worth I think. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 12:36, 9 January 2017 (UTC)

:::In my drafts if a newer source is just two years and cites the same or similar claim I use the newer source. If the claim is similar with the newer source I make a slight tweak to the text. I always keep things fresh. Its that simple. [[User:QuackGuru|<font color="vermillion">'''QuackGuru'''</font>]] ([[User talk:QuackGuru|<font color="burntorange">talk</font>]]) 12:43, 9 January 2017 (UTC)

{{od}} This [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497800/ 2011 review] supports the NIH source and discusses research in human subjects:

{{quote|All three drugs [methamphetamine, d-amphetamine, and MDMA] have addictive potential and can lead to varying degrees of drug dependence...approximately 15% of routine MDMA users recently fit the diagnostic criteria for MDMA dependence...Comparable results have been reported following MDMA abuse in the United Kingdom (McCambridge et al., 2005). Furthermore, MDMA and D-AMPH were reported to have similar reinforcing effects in people during a controlled laboratory study (Tancer and Johanson, 2003). Thus, there is some epidemiological evidence to support the addictive potential of MDMA as described in animal studies, although to a much lesser extent than that of either METH or D-AMPH.<ref>{{cite journal|last1=Steinkellner|first1=Thomas|last2=Freissmuth|first2=Michael|last3=Sitte|first3=Harald H.|last4=Montgomery|first4=Therese|title=The ugly side of amphetamines: short- and long-term toxicity of 3,4-methylenedioxymethamphetamine (MDMA, ‘Ecstasy’), methamphetamine and d-amphetamine|journal=Biological Chemistry|date=1 January 2011|volume=392|issue=1-2|doi=10.1515/BC.2011.016}}</ref>}}

[[User:Permstrump|<font color="indigo">—'''PermStrump'''</font>]][[User Talk:Permstrump|<font color="steelblue">(<u>talk</u>)</font>]] 00:32, 10 January 2017 (UTC)

Dependence and addiction are used together in this study...it doesnt seem very good.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 00:54, 10 January 2017 (UTC)

:It seems more useful for quantifying the dependence liability than addiction liability. Haven't finished reading it yet though. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 01:06, 10 January 2017 (UTC)

:The current classification of MDMA puts it on par with [[amphetamine]] and (and [[phenethylamine]] when it's coadministered with a MAO-B inhibitor) in terms of its addiction and dependence liability, while being less addictive and less prone to induce psychological dependence than [[methamphetamine]] or [[cocaine]]. This is in part based upon usage demographics (i.e., usage patterns and the doses administered), in part based upon clinical evidence, and in part based upon the molecular neuropharmacology of each drug. I'm not aware of any substituted amphetamines that have been shown/documented to induce physical dependence. Cocaine, which is a nonselective MA reuptake inhibitor, doesn't do this, so I wouldn't expect a nonselective MA releasing agent to cause this either. It is worth pointing out that amphetamine, MDMA, and methamphetamine directly affect glutamate neurotransmission in some cell types in the brain via internalization of neuronal and/or astroglial [[EAAT]]s in addition to monoamine neurotransmission via several mechanisms that affect VMAT2/DAT/NET/SERT. Alterations in synaptic glutamate concentrations in the NAcc, which is one region where these drugs affect EAATs, directly affects the development and maintenance of an addiction as a result of changes in postsynaptic glutamate receptor signaling (case in point: altered NMDA receptor signaling in the NAcc is strongly implicated in the development of addiction to [[ketamine]] and [[phenylcyclidine]]). [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 21:15, 10 January 2017 (UTC)

:So, in a nutshell, I don't see a point in trying to look for refs to change this. These "liability" parameters are really just rather subjective ratings of how likely a drug is to induce addiction or dependence '''relative to''' other drugs which have addiction/dependence liability ratings on Wikipedia. Individual liability ratings IMO are fairly meaningless without context (i.e., comparison to other drugs which induce addiction or dependence). [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 21:19, 10 January 2017 (UTC)

Firstly, phenethylamine with an MAO is not anything that is researched. I have only hear anecdotes related to it so I don't know why you mentioned it. Secondly, "The current classification of MDMA puts it on par with [[amphetamine]]". Source? We have found sources that say a variety of things, some say addictive(no magnitude), and others say not addictive. Currently, there is no quantitive data on addictiveness, the 15% is meaningless (of what population? Context of use?). The only real good way to measure addictiveness is with progressive ratio self administration break point in the same lab setting, which hasn't been done with MDMA to my knowledge, I have only found studies comparing cocaine, nicotine, cathinone, morphine and methamphetamine. Given the inconsistency, I think that low would be the best classification for addiction liability on this page, a sort of compromise/average given the sources we have. It's really the best we can do, or we can remove the statistic from the chart overall....because its kinda of hard to quantify and kinda dumb.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 00:31, 11 January 2017 (UTC)

:{{tq|Firstly, phenethylamine with an MAO is not anything that is researched. }} You're correct.

:{{tq|I have only hear anecdotes related to it so I don't know why you mentioned it.}} - re: "...in part based upon the molecular neuropharmacology of each drug"

:{{tq|Secondly, "The current classification of MDMA puts it on par with [[amphetamine]]". Source?}} - [[amphetamine]]. I was referring to the current classification ''on Wikipedia''.

:I agree that studies with each drug which utilize a standardized reinforcement schedule which is appropriate for studying self administration would be the ideal sources to use set these parameters and cite them. I'm not aware of any body of research like that though.

:I don't see any reasonable justification to set the addiction liability of MDMA lower than all other dopamine releasing agents based upon the current evidence. The only ref that we have which compares it to other drugs states that its liability is "relatively small", and "moderate" is "relatively small" compared to "high", which drugs like cocaine, methamphetamine, and heroin are rated. Seeing as how those are the three most widely used recreational "hard drugs" globally, I have no clue what else the term "relatively" in the phrase "relatively small" would be referring to in that reference. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 01:02, 11 January 2017 (UTC)

::Well you cant base addiction liability on pharmacology on structure. Firstly, it is well known that the speed DA activity heavily influences the euphoria experienced, and therefore the addictive potential. Secondly, given that MDMA is largely a serotonergic drug, this should prevent addiction, as 5-HT acting drugs have a tendency to create a satiation of desire-kind of like having too much of a food you like. That is why although mildly euphoric, drugs like LSD and psilocybin are not addictive. So, no. You cant say "because MDMA is a phenethylamine, it is moderately addictive". Thats way too far of a jump, not in biology. Maybe in math, maybe in physics(although probably not), but not in biology.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 01:49, 11 January 2017 (UTC)

:::It's probably best to ask me what I have in mind when I said "in part based upon the molecular neuropharmacology of each drug" than to assume you know what I'm referring to. Just like other dopamine releasing agents, and as stated verbatim in the article: {{tq|MDMA has been shown to induce [[ΔFosB]] in the [[nucleus accumbens]].<ref name="MDMA ΔFosB">{{cite journal |vauthors=Olausson P, Jentsch JD, Tronson N, Neve RL, Nestler EJ, Taylor JR | title = DeltaFosB in the nucleus accumbens regulates food-reinforced instrumental behavior and motivation | journal = J. Neurosci. | volume = 26 | issue = 36 | pages = 9196–204 | date = September 2006 | pmid = 16957076 | doi = 10.1523/JNEUROSCI.1124-06.2006 | url = http://www.jneurosci.org/content/26/36/9196.full}}</ref>}} MDMA and amphetamine induce DA/glutamate release into NAcc D1-type MSNs, which necessarily triggers [[template:psychostimulant addiction#Image|the exact same signaling cascade into those neurons to induce ΔFosB expression]]. Those neurons don't even express serotonin receptors, so the notion that it being a serotonin releasing agent somehow changes things is asinine. The fact that MDMA and amphetamine are structural or even functional analogs is also irrelevant - the only relevant neuropharmacological aspect of these drugs in relation to addiction is how they affect neurotransmission at synapses between glutamate/dopamine neurons and D1-type NAcc medium spiny neurons. And, FWIW, the ref above that states that MDMA induces NAcc ΔFosB expression also examined MDMA, cocaine, nicotine, and amphetamine on a progressive ratio reinforcement schedule and measured their break points:[http://www.jneurosci.org/content/jneuro/26/36/9196/F1.large.jpg] [http://www.jneurosci.org/content/jneuro/26/36/9196/F2.large.jpg?width=800&height=600&carousel=1]. There's a fairly clear consensus on this talk page not to change the addiction liability, so stop edit warring. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 02:13, 11 January 2017 (UTC)

::::What is asinine is think think of addiction solely from a biochemical viewpoint. Yes FOSB expression is related to addiction, but you are forgetting addiction is at its core a behavioral phenomenon. If 2 refs explicitly state MDMA is not addictive in humans, although old, they outweigh a newer ref that suggests it induces FOSB expression in the NAcc. That is ridiculous. Stop reverting to moderate. Best to remove it during this discussion, and I think if we cant come to a conclusion, given how it is impossible to quantify addictiveness potential and the stat is stupid as is, we should remove it.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 03:06, 11 January 2017 (UTC)

:::::"DESPITE THE IMPORTANCE OF NUMEROUS PSYCHOSOCIAL FACTORS, AT ITS CORE, DRUG ADDICTION INVOLVES A BIOLOGICAL PROCESS" - very first words of PMID 24459410; no emphasis was added - that all caps is from the source.

:::::This very recent review on the role of ΔFosB in addiction states outright that the degree of ΔFosB induction by a drug is a biomarker that can be used to measure the addictiveness (i.e., addiction liability) of a drug.<ref name="What the ΔFosB?">{{cite journal | vauthors = Ruffle JK | title = Molecular neurobiology of addiction: what's all the (Δ)FosB about? | journal = The American Journal of Drug and Alcohol Abuse | volume = 40 | issue = 6 | pages = 428–37 | date = Nov 2014 | pmid = 25083822 | doi = 10.3109/00952990.2014.933840 | quote = <br />ΔFosB as a therapeutic biomarker<br />The strong correlation between chronic drug exposure and ΔFosB provides novel opportunities for targeted therapies in addiction (118), and suggests methods to analyze their efficacy (119). Over the past two decades, research has progressed from identifying ΔFosB induction to investigating its subsequent action (38). It is likely that ΔFosB research will now progress into a new era – the use of ΔFosB as a biomarker. If ΔFosB detection is indicative of chronic drug exposure (and is at least partly responsible for dependence of the substance), then its monitoring for therapeutic efficacy in interventional studies is a suitable biomarker (Figure 2). Examples of therapeutic avenues are discussed herein.&nbsp;...<br /><br />Conclusions<br />ΔFosB is an essential transcription factor implicated in the molecular and behavioral pathways of addiction following repeated drug exposure. The formation of ΔFosB in multiple brain regions, and the molecular pathway leading to the formation of AP-1 complexes is well understood. The establishment of a functional purpose for ΔFosB has allowed further determination as to some of the key aspects of its molecular cascades, involving effectors such as GluR2 (87,88), Cdk5 (93) and NFkB (100). Moreover, many of these molecular changes identified are now directly linked to the structural, physiological and behavioral changes observed following chronic drug exposure (60,95,97,102). New frontiers of research investigating the molecular roles of ΔFosB have been opened by epigenetic studies, and recent advances have illustrated the role of ΔFosB acting on DNA and histones, truly as a ‘‘molecular switch’’ (34). '''As a consequence of our improved understanding of ΔFosB in addiction, it is possible to evaluate the addictive potential of current medications (119), as well as use it as a biomarker for assessing the efficacy of therapeutic interventions (121,122,124).''' Some of these proposed interventions have limitations (125) or are in their infancy (75). However, it is hoped that some of these preliminary findings may lead to innovative treatments, which are much needed in addiction. }}</ref> I'd suggest that you not offhandedly disregard a field of addiction research which is extremely relevant to this conversation simply because you don't know much about it. The notion that addiction isn't a brain disorder is simply outrageous to me; seriously, what do people who advocate otherwise actually think "thought" and "behavior" comes from if not neurons within the brain? The foot? Vacuum? A magical pink bunny in the sky? Nowhere - that it just simply happens without a mechanism? [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 03:21, 11 January 2017 (UTC)

::::::LMAO. I never said FOSB expression should be discounted entirely, nor did I say addiction wasn't a neurological disorder. I agree FOSB is an important in addiction. However, addiction is diagnosed by behavioral traits, not FOSB expression. The reason that FOSB expression is not used as a diagnosis tool is because there are more components to addiction than FOSB expression(that an measurement). If you want to put FOSB expression in the page, then do so, however dont use that as support for putting "Addiction liability:Moderate" down. That is pure ignorance. Don't discount how complex biology is because you don't have a good understanding. [[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 03:49, 11 January 2017 (UTC)

{{outdent}}

Incidentally, if you put a colon before a paragraph the paragraph is indented. Adding a colon for each "level" of the discussion helps to keep the discussion organized. Last I heard, the reason FOSB isn't used as a diagnosis tool is because they'd have to do a biopsy of your brain tissue. This is somewhat difficult to do when the subject wants to remain alive/functional. The current diagnostic criteria are a bit screwed up at the moment if you've seen our [[DSM-5]] article. FOSB is necessary and sufficient for addiction. The relationship between the two is so close that researchers are looking into medication that will treat addiction by reducing FOSB expression. In any case, I think all the current sources support a 'moderate' rating for addiction liability. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 04:05, 11 January 2017 (UTC)

:{{U|Petergstrom}}, my issue with your 2007 sources is that you were using them to overwrite newer sources. [[WP:MEDDATE]] is a rule of thumb, not a hard rule. I don't think your recent edits are improving this article. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 04:10, 11 January 2017 (UTC)

The FOSB article would need a secondary source stating that this is equivalent to an indication of moderate addiction liability-an editor cant make that decision. The addiction liability stat needs to go, as the only sources that specifically state addiction liability in humans(which happen to be stated as zero) are too old to be used. Either a newer source specifically stating that the addiction liability in humans in moderate needs to be found, the older sources need to be used, or the stat needs to go.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 04:09, 11 January 2017 (UTC)

:We use the best available sources for any claim. There are multiple factors that determine quality - age is only one of them. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 04:12, 11 January 2017 (UTC)

{{U|Sizeofint}} Lots of research has been done in the last 10 years. We need to find those sources to implement them in the article. I am currently compiling some.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 04:13, 11 January 2017 (UTC)

:Then why don't you wait until you have them before you start removing content? [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 04:18, 11 January 2017 (UTC)

I was referring to the addictiveness. If there is no viable source for "moderate" rating, then '''why is it there????'''. It should be gone until we have a good source for it. An study on FOSB does not allow an editor to conclude "Moderate addiction liability". A study on FOSB, can go in the effects section, not in the side bar under addiction liability. We have older sources explicitly stating no addiction liability in humans, but they are too old, however we have no newer studies explicitly contradicting them. There is of course the study on dependence, but thats not enough. In the dependence section, that should be stated, but not in the side bar under addiction lability. I don't even see where the source on MDMA decision making states it is addictive. I see a mention that decision making may play a role in addiction, and that it(addiction to another drug) was an exclusion criteria for a study. Did I miss something. Furthermore, the quotation from the book only mentions neurotoxicity, did I miss something again? Also the FOSB study used rats...I mean if the studies suggesting addiction(albeit never saying "Moderate") are rat studies, or studies using old criteria and the term dependence, then I really don't think there is enough evidence to put down "Moderate" and "15%"[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 05:21, 11 January 2017 (UTC)

I see these quotations from the 15% study

{{Quote|These observations further question the relevance of animal experiments that rely on self-administration to gauge the addictive properties of MDMA. As outlined earlier, MDMA is not readily self-administered, indicating that its rewarding properties are modest in comparison to d-AMPH or cocaine.}}

{{Quote|However, the results of animal behavioural and toxicity studies cannot be readily extrapolated to patients. This is particularly true for MDMA where major pharmacokinetic differences exist between commonly used laboratory animals. Thus, extensive longitudinal research in clinical settings is necessary to dissect confounding environmental factors such as polytoxicomanic drug use and pre-existing mental conditions from amphetamine-induced toxicity in the future. It is safe to predict that the availability of good data and reliable epidemiological evidence will also allow for a more temperate approach to the abuse and therapeutic use of amphetamines in the future.}}

{{Quote|Studies on ‘MDMA dependence’ in humans are often confounded by mixed sample populations of poly-drug users and typically rely on subjective user reports. }}

{{Quote|Few direct correlations exist between MDMA abuse and human disease states other than addiction.}}

{{Quote|All three drugs have addictive potential and can lead to varying degrees of drug dependence.}}

{{Quote|MDMA is clearly a reinforcer in animal studies, but the mechanism of MDMA-induced drug dependence is still under scrutiny.}}

:::You have to read through the information about limitations and pick out the nuggets of information the authors feel have conclusive support. The quote in the book is used to support a statement on neurotoxicity above. I'll see if I have access to the book. {{tq|If there is no viable source for "moderate" rating, then why is it there????}} Well the sources so far support a low or moderate rating. Seppi believes the molecular biology source is more in line with moderate. I don't have a strong feeling on this so I'm inclined to follow his judgement on this. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 05:38, 11 January 2017 (UTC)

:::{{U|Petergstrom}} that quote is talking about neurotoxicity which is not the same thing as cognitive impairment. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 06:00, 11 January 2017 (UTC)

::::So then why is it listed as a source for moderate addiction? Also, the reason Seppi gave for a biological support of moderate is only FOSB expression in rats, and an editor cannot make that jump. The sources we have don't support anything...except the old sources which support none. [[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 06:07, 11 January 2017 (UTC)

:::::The source with that neurotoxicity quote supporting the addiction liability is used in multiple places, one of which is the discussion of neurotoxicity. That is why the quote is there. Why do you think the 2017 source doesn't support at least a low rating? The best approach is to gather good recent sources (or at least sources as good or better than what we already have) to make a case. If sources conflict we may be able to compromise with Low / Moderate or similar. This reference, for example, states {{tq|MDA and MDMA are less reinforcing than amphetamine...}}<ref>{{cite book|last1=Saiz|first1=senior editor Richard K. Ries ; associate editors David A. Fiellin, Shannon C. Miller, Richard|title=Principles of addiction medicine.|date=2009|publisher=Wolters Kluwer/Lippincott Williams & Wilkins|location=Philadelphia|isbn=9780781774772|page=226|edition=4th ed.|url=https://books.google.com/books?id=j6GGBud8DXcC&pg=PA226&dq=mdma+addiction&hl=en&sa=X&ved=0ahUKEwi-6KWrt7nRAhXFilQKHRtJAQkQ6AEIHDAA#v=onepage&q=mdma%20addiction&f=false}}</ref> [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 06:24, 11 January 2017 (UTC)

I completely support a low rating, but I support even more a none-low rating or removal of the rating in the sidebar, and rather a discussion below in effects. [[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 06:31, 11 January 2017 (UTC) Im gonna sum up source

:It's laughable that you think my comments on a talk page have to adhere to WP:MEDRS. This source has supported the addiction liability statement ever since I added it over two years ago.<ref name="NHM-MDMA" /> The statement that it makes isn't vague/ambiguous or open to interpretation. The parameter is set to "moderate" because this is the default rating that I've given to any addictive drug unless there's a reason to set it lower or higher based upon the sources that I've used to cite addiction-related content in the article or any relevant clinical evidence that I subsequently become aware of. In other words, if a drug is addictive, it's probably going to be rated moderate. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 09:30, 11 January 2017 (UTC)

===Arbitrary break===

For addictiveness liability

*https://www.drugs.com/illicit/mdma.html drugs.com is not MEDRS

::I'm actually not sure whether or not we consider drugs.com MEDRS. I think in general we try to use better sources which are almost always available [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 08:41, 11 January 2017 (UTC)

*http://www.eurekaselect.com/71315/article/cannabinoids-opioids-and-mdma-neuropsychological-interactions-related-addiction this source which pubmed provide two external links for, both costing 50-60 dollars. It does not state anything other than MDMA being concurrently used with other drugs may affect addiction

::Doesn't look like I have access. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 08:46, 11 January 2017 (UTC)

*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931692/ this source which as stated above uses the DSM 4, conflates addiction and dependence, and never explicitly states that MDMA is addictive, although does infer it.

::{{tq|Despite having a compulsive use factor, ecstasy dependence is not typically as profound as the dependence that can occur in heavy users of alcohol, cocaine, methamphetamine, opioids, and tobacco.}} Compulsive use corresponds to addiction. I think this supports a low to moderate rating. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 08:56, 11 January 2017 (UTC)

*https://www.drugabuse.gov/publications/drugfacts/mdma-ecstasymolly which refers to animal self administration [[WP:MEDANIMAL]], and not to addiction

::Yes, they just waffle. Not too helpful for our purposes. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 08:57, 11 January 2017 (UTC)

*https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497800/ this which, again, never explicitly states MDMA's addictive potential, although does conflate and indicate dependence

*Seppi claiming that FOSB expression in rats is sufficient to jump to a magnitude of addiction, which firstly relies on WP:MEDANIMAL and is an inference an editor cannot make {{Quote|It's probably best to ask me what I have in mind when I said "in part based upon the molecular neuropharmacology of each drug" than to assume you know what I'm referring to. Just like other dopamine releasing agents, and as stated verbatim in the article: MDMA has been shown to induce ΔFosB in the nucleus accumbens.[7] MDMA and amphetamine induce DA/glutamate release into NAcc D1-type MSNs, which necessarily triggers the exact same signaling cascade into those neurons to induce ΔFosB expression. Those neurons don't even express serotonin receptors, so the notion that it being a serotonin releasing agent somehow changes things is asinine. The fact that MDMA and amphetamine are structural or even functional analogs is also irrelevant - the only relevant neuropharmacological aspect of these drugs in relation to addiction is how they affect neurotransmission at synapses between glutamate/dopamine neurons and D1-type NAcc medium spiny neurons. And, FWIW, the ref above that states that MDMA induces NAcc ΔFosB expression also examined MDMA, cocaine, nicotine, and amphetamine on a progressive ratio reinforcement schedule and measured their break points:[12] [13]. There's a fairly clear consensus on this talk page not to change the addiction liability, so stop edit warring}}{{Quote|"DESPITE THE IMPORTANCE OF NUMEROUS PSYCHOSOCIAL FACTORS, AT ITS CORE, DRUG ADDICTION INVOLVES A BIOLOGICAL PROCESS" - very first words of PMID 24459410; no emphasis was added - that all caps is from the source.

This very recent review on the role of ΔFosB in addiction states outright that the degree of ΔFosB induction by a drug is a biomarker that can be used to measure the addictiveness (i.e., addiction liability) of a drug.[8] I'd suggest that you not offhandedly disregard a field of addiction research which is extremely relevant to this conversation simply because you don't know much about it. The notion that addiction isn't a brain disorder is simply outrageous to me; seriously, what do people who advocate otherwise actually think "thought" and "behavior" comes from if not neurons within the brain? The foot? Vacuum? A magical pink bunny in the sky? Nowhere - that it just simply happens without a mechanism? Seppi333 (Insert 2¢) 03:21, 11 January 2017 (UTC)}}

Sources indicating no addiction

*{{cite journal|last1=Pentney|first1=Alana|title=An Exploration of the History and Controversies Surrounding MDMA and MDA|journal=Journal of Psychoactive Drugs|date=Sept 2001|volume=33|issue=3|pages=213-221|url=http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.688.6834&rep=rep1&type=pdf}}

::*Although old explicitly states ""It has been shown that MDMA is not addictive in humans (Beck & Rosenbaum 1 994; Peroutka 1 990a; Riedlinger 1 985)"

::::Riedlinger 1985 is some of the very earliest research on MDMA. I've use Beck & Rosenbaum extensively in the history section. It is a fascinating read but I don't know why the author would cite them for medical information. In any case, we have newer and higher quality sources so this doesn't hold much weight. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 09:00, 11 January 2017 (UTC)

*{{cite journal|last1=Jansen|first1=K. L.|title=Ecstasy (MDMA) dependence|journal=Drug and Alcohol Dependence|date=7 January 1999|volume=53|issue=2|pages=121–124|url=https://www.ncbi.nlm.nih.gov/pubmed/10080038|issn=0376-8716}} describes rare cases of addiction criteria being met with a drug that is generally considered non-addictive, evidence for at least a low rating. {{Quote|Methylenedioxymethamphetamine (MDMA) is generally described as non-addictive. However, this report describes three cases in which criteria for dependence were met.}}

::::Yes, we have newer better sources now. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 09:04, 11 January 2017 (UTC)

There is a mountain of sources cited for addictiveness, but none of them are substantial...The two(old) sources that we have that actually explicitly mention addictiveness in humans as addictiveness, not dependence, mention none potential. [[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 08:09, 11 January 2017 (UTC)

:This is a good start. I'm still looking through some Google Books entries. So far the sources state the liability is less than amphetamine and alcohol - substances we currently rank as moderately addictive. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 09:04, 11 January 2017 (UTC)

::{{tq|MDMA's addictive liability appears to be lower than that of other drugs of abuse....}}<ref>{{cite book|last1=Mack|first1=Avram H.|last2=Brady|first2=Kathleen T.|last3=Miller|first3=Sheldon I.|last4=Frances|first4=Richard J.|title=Clinical Textbook of Addictive Disorders|publisher=Guilford Publications|isbn=9781462521692|page=169|url=https://books.google.com/books?id=88W_CwAAQBAJ&pg=PA171&dq=mdma+addiction&hl=en&sa=X&ved=0ahUKEwi-6KWrt7nRAhXFilQKHRtJAQkQ6AEIODAF#v=onepage&q=mdma%20addiction&f=false|language=en}}</ref> Here the authors are mostly comparing MDMA to cocaine and methamphetamine, drugs we currently say have a high addiction liability. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 09:56, 11 January 2017 (UTC)

::{{tq|In terms of evidence for dependence-syndrome-like patterns of use, and thus diagnosability of MDMA use, historically there has been little evidence for it; the drug is typically used weekly or less at a scale inconsistent with traditional notions of drug dependence....}}<ref>{{cite book|last1=Epstein|first1=edited by Barbara S. McCrady, Elizabeth E.|title=Addictions : a comprehensive guidebook|date=2013|publisher=Oxford University Press|location=Oxford|isbn=9780199753666|page=299|edition=Second edition.}}</ref> I can't tell if they are conflating dependence with addiction or not. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 10:20, 11 January 2017 (UTC)

:::Any ref that covers diagnosis will have that issue. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 10:25, 11 January 2017 (UTC)

::::The APA really screwed the proverbial pooch on this one. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 10:36, 11 January 2017 (UTC)

::{{tq|It seems to present a smaller addiction potential than cocaine or methamphetamine.}}<ref>{{cite web|last1=Favrod-Coune|first1=Thierry|last2=Broers|first2=Barbara|title=The Health Effect of Psychostimulants: A Literature Review|url=10.3390/ph3072333|website=Pharmaceuticals|pages=2333–2361|language=en|doi=10.3390/ph3072333|date=22 July 2010}}</ref> [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 10:36, 11 January 2017 (UTC)

* PMID 23627786 (already cited in the article, from 2013) says (extended quote since it is paywalled): "While MDMA appears to be a promising treatment for at least one psychiatric disorder when combined with psychotherapy, it also possesses moderate abuse potential. Rodents and primates will self-administer MDMA [75-77]. For instance, monkeys will regularly self-administer MDMA, though they will pay a higher cost in lever presses for amphetamine or methamphetamine [78, 79]. The mood elevation produced by MDMA can be experienced as rewarding [see for instance 64, 65, 74, 80]. A national survey found that an estimated 2.5% of youths aged 12-17 and 12.4% of young adults aged 18 to 24 report using ecstasy at least once in their lives [81] and 9.1% reported use upon a second follow-up. Of those, 0.6% of this representative sample of young people, [82] and a higher percentage of polydrug users [83], report developing ecstasy dependence, though estimates vary between nations and over time, with polydrug users reporting more abuse of ecstasy. Regular and heavy users will take ecstasy once or twice a week or once every two weeks rather than on a daily basis. However, some people report problems arising from their use. Hence, like psychostimulants and unlike classic psychedelics, MDMA is associated with some abuse liability." [[User:Jytdog|Jytdog]] ([[User talk:Jytdog|talk]]) 10:59, 11 January 2017 (UTC)

::Is abuse liability the same thing as addiction liability? [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 18:43, 11 January 2017 (UTC)

:::I didn't notice this question earlier. No, not necessarily. Abuse liability reflects a drug's potential to be "abused" recreationally. The recreational potential of a drug definitely is a factor that affects a drug's addiction liability since the recreational potential of a drug is reflected in usage patterns, and usage patterns directly affect the rate at which an addiction develops; however, abuse liability is not equivalent to addiction liability in part because some drugs of abuse are not actually addictive. For example, LSD and a number of other hallucinogens are non-addictive drugs of abuse.<ref name="NHM-MDMA">{{cite book |vauthors=Malenka RC, Nestler EJ, Hyman SE |veditors=Sydor A, Brown RY | title = Molecular Neuropharmacology: A Foundation for Clinical Neuroscience | year = 2009 | publisher = McGraw-Hill Medical | location = New York | isbn = 9780071481274 | page = 375 | edition = 2nd | chapter = Chapter 15: Reinforcement and Addictive Disorders | quote= Several other classes of drugs are categorized as drugs of abuse but rarely produce compulsive use. These include psychedelic agents, such as lysergic acid diethylamide (LSD), which are used for their ability to produce perceptual distortions at low and moderate doses. The use of these drugs is associated with the rapid development of tolerance and the absence of positive reinforcement (Chapter 6). Partial agonist effects at 5HT2A receptors are implicated in the psychedelic actions of LSD and related hallucinogens. 3,4-Methylenedioxymethamphetamine (MDMA), commonly called ecstasy, is an amphetamine derivative. It produces a combination of psychostimulant-like and weak LSD-like effects at low doses. Unlike LSD, MDMA is reinforcing—most likely because of its interactions with dopamine systems—and accordingly is subject to compulsive abuse. The weak psychedelic effects of MDMA appear to result from its amphetamine-like actions on the serotonin reuptake transporter, by means of which it causes transporter-dependent serotonin efflux. MDMA has been proven to produce lesions of serotonin neurons in animals and humans.}}</ref> [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 01:47, 15 January 2017 (UTC)

:::It's worth noting that the way the above ref is using the phrase "abuse liability" isn't consistent with what I've just stated. What I've explained above is simply the literal meaning of the phrase "abuse liability". [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 01:51, 15 January 2017 (UTC)

So has the evidence pointed at any point to a moderate addiction liability? No. The reverts were wrong given no consensus from talk, but from the evidence....that is a totally different story. The evidence presented before now has not said anything about addiction, accept the outdated sources, which say no liability. Sizeofint's sources mention that the addiction potential is less than drugs right now considered to have moderate and high addiction potentials at the moment, making it logically a low addiction potential. Is there a general consensus about that? User:Jytdogs new source mentions some abuse liability, but does not mention magnitude, relative magnitude, nor does it distinguish between dependence and addiction, rather overall drug abuse. I still think low is the best choice for addiction liability.[[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 16:48, 11 January 2017 (UTC) [[User:Petergstrom|Petergstrom]] ([[User talk:Petergstrom|talk]]) 16:48, 11 January 2017 (UTC)

:All sources admit an addiction liability lower than methamphetamine and cocaine. This certainly places the upper bar at moderate as we have already established. A few of sources, but not all, go further and state the addiction liability is lower than amphetamine or alcohol. I would support saying an addiction liability of 'moderate – low' based on this. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 18:56, 11 January 2017 (UTC)

::That seems reasonable. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 19:09, 11 January 2017 (UTC)

===Section references===

{{talk reflist|section}}

== Cognitive impairments from long-term MDMA use ==

Since I know this is going to come up again, I figure I might as well just address it now. As noted in [https://en.wikipedia.org/w/index.php?title=MDMA&diff=759464345&oldid=759451546 my recent edit summary], this review<ref name="Abstinent MDMA fMRI review">{{cite journal | vauthors = Garg A, Kapoor S, Goel M, Chopra S, Chopra M, Kapoor A, McCann UD, Behera C | title = Functional Magnetic Resonance Imaging in Abstinent MDMA Users: A Review | journal = Curr. Drug Abuse Rev. | volume = 8 | issue = 1 | pages = 15–25 | date = 2015 | pmid = 25731754 | doi = 10.2174/1874473708666150303115833| quote = <br />• Chronic MDMA use results in serotonergic toxicity, thereby altering the regional cerebral blood flow that can be studied using fMRI.<br />• The effects of chronic MDMA use have been analysed in various neurocognitive domains such as working memory, episodic memory, semantic memory, visual stimulation, motor function and impulsivity.&nbsp;...<br /> Structural neuroimaging in MDMA users has shown reduction in brain 5-HT transporter (5-HTT) [18-21] and 5-HT2a receptor levels [22-24] using positron emission tomography (PET) or single photon emission computed tomography (SPECT) and reduced grey matter density in various brain regions using voxel based morphometry method (VBM) [25]. Chemical Neuroimaging, assaying the levels of myoinositol (MI) and N-acetylaspartate (NAA) in the brains of MDMA users using proton magnetic resonance spectroscopy (MRS), has not revealed any consistent results [17, 26-29]. Functional magnetic resonance imaging (fMRI) studies have shown task evoked differences in regional brain activation, measured as blood oxygen level dependent (BOLD) signal intensity and/or spatial extent of activation, in MDMA users and controls [30-33].&nbsp;... Neurocognitive studies, in MDMA users, have consistently revealed dose related memory and learning problems [35-38]&nbsp;... Serotonergic innervation is known to regulate the cerebral microvasculature. Chronic MDMA use results in serotonin toxicity, therefore MDMA users are expected to have altered regional blood flow detectable in fMRI [17].&nbsp;... Animal data has suggested that MDMA is selectively more toxic to the axons more distal to the brainstem cell bodies, that is, those present mainly in the occipital cortex [54, 55]. Also, human PET and SPECT studies have revealed significant reductions in serotonin transporter binding, most evident in the occipital cortex [18, 20]&nbsp;... The effects of poly-drug exposure may result in additive neurotoxicity or mutual neuro-protection. MDMA is known to induce hyperthermia which is a prooxidant neurotoxic condition [65]. Hyperthermia is known to accentuate the neurotoxic potential of MDMA as well as methamphetamine [66, 67]. On the other hand, lowering of the core body temperature has been shown to have a neuroprotective effect.}}</ref> (the full text can be accessed in [https://docs.google.com/viewer?a=v&pid=sites&srcid=ZGVmYXVsdGRvbWFpbnxzZXBwaWx1cnZlc3BhbmNha2VzfGd4Ojc3YjJjZjYyYzljZmNhNmM this link]) is examining the neural correlates of cognitive impairments in MDMA users. In other words, using fMRI, it's examining the functional differences in specific brain regions between healthy individuals and chronic MDMA users that correlate with specific cognitive impairments. The ref states that these cognitive impairments - in particular, those related to learning and memory - have been consistently documented in humans. It also states that fMRI studies which examine the neural correlates of these cognitive impairments have produced inconsistent results. In plain English, this means that the research which has attempted to identify the neurotoxic/neurodegenerative effects of MDMA that correlate with specific cognitive function deficits is not consistent.

Inconsistency in findings that link MDMA-induced neurotoxicity to MDMA-induced cognitive impairments is not the same thing as inconsistency in findings of MDMA-induced neurotoxicity or inconsistency in findings of MDMA-induced cognitive impairments. Consequently, the source is not contradicting itself and the current article content on deficits in cognitive function that is cited by this source does not contradict this source; rather, that content is directly supported by the quote in the citation. [[User:Seppi333|'''<font color="#32CD32">Seppi</font>''<font color="Black">333</font>''''']]&nbsp;([[User Talk:Seppi333|Insert&nbsp;'''2¢''']]) 22:44, 11 January 2017 (UTC)

{{reflist talk}}

== Semi-protected edit request on 16 March 2017 ==

{{edit semi-protected|MDMA|answered=yes}}

Replace citation [21] in the following sentence "Researchers are investigating whether a few low doses of MDMA may assist in treating severe, treatment-resistant posttraumatic stress disorder (PTSD).[12][21]" with this citation: Amoroso, T., & Workman, M. (2016). Treating posttraumatic stress disorder with MDMA-assisted psychotherapy: A preliminary meta-analysis and comparison to prolonged exposure therapy. Journal of Psychopharmacology, 30(7), 595-600. [[Special:Contributions/2601:18B:8200:61D8:7CB6:AB0F:5BE5:4F54|2601:18B:8200:61D8:7CB6:AB0F:5BE5:4F54]] ([[User talk:2601:18B:8200:61D8:7CB6:AB0F:5BE5:4F54|talk]]) 00:12, 17 March 2017 (UTC)

:{{done}} [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 00:31, 17 March 2017 (UTC)

==Paste==

The following has some useful references but I think it is redundant with current content and too loose on efficacy. [[User:Sizeofint|Sizeofint]] ([[User talk:Sizeofint|talk]]) 20:37, 18 May 2017 (UTC)

MDMA is known to improve sociability, friendliness, [[extroversion]], to increase [[empathy]] and feelings of closeness with others, and to reduce interpersonal defensiveness.<ref>{{cite journal|last1=Scahill|first1=Lawrence|last2=Anderson|first2=George M.|title=Is ecstasy an empathogen?|journal=Biological psychiatry|date=15 December 2010|volume=68|issue=12|pages=1082–1083|doi=10.1016/j.biopsych.2010.10.020|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3033697/|accessdate=18 May 2017|issn=0006-3223}}</ref><ref>{{cite journal|last1=Bedi|first1=Gillinder|last2=Hyman|first2=David|last3=de Wit|first3=Harriet|title=Is ecstasy an ‘empathogen’? Effects of MDMA on prosocial feelings and identification of emotional states in others|journal=Biological psychiatry|date=15 December 2010|volume=68|issue=12|pages=1134–1140|doi=10.1016/j.biopsych.2010.08.003|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2997873/|accessdate=18 May 2017|issn=0006-3223}}</ref><ref>{{cite journal|last1=Kamilar-Britt|first1=Philip|last2=Bedi|first2=Gillinder|title=The Prosocial Effects of 3,4-methylenedioxymethamphetamine (MDMA): Controlled Studies in Humans and Laboratory Animals|journal=Neuroscience and biobehavioral reviews|date=18 May 2017|volume=57|pages=433–446|doi=10.1016/j.neubiorev.2015.08.016|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4678620/|accessdate=18 May 2017|issn=0149-7634}}</ref><ref>{{cite journal|last1=Bedi|first1=Gillinder|last2=Phan|first2=K. Luan|last3=Angstadt|first3=Mike|last4=de Wit|first4=Harriet|title=Effects of MDMA on sociability and neural response to social threat and social reward|journal=Psychopharmacology|date=18 May 2017|volume=207|issue=1|pages=73–83|doi=10.1007/s00213-009-1635-z|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3328967/|accessdate=18 May 2017|issn=0033-3158}}</ref><ref>{{cite web|title=Ecstasy ingredient touted as treatment for anxiety in autism {{!}} Spectrum {{!}} Autism Research News|url=https://spectrumnews.org/news/ecstasy-ingredient-touted-treatment-anxiety-autism/|website=Spectrum {{!}} Autism Research News|accessdate=18 May 2017|date=16 November 2016}}</ref> These effects are relevant to people with social anxiety and a group of researchers find that MDMA has therapeutic benefits for alleviating social anxiety.<ref>{{cite book|last1=Syder|first1=Alexander|title=MDMA Case Study. A Case for Decriminalization or Prohibition?|publisher=GRIN Verlag|isbn=9783668046870|url=https://books.google.de/books?id=DCWQCgAAQBAJ&pg=PA1|accessdate=18 May 2017|language=en}}</ref><ref>{{cite book|last1=Ingersoll|first1=R. Elliott|last2=Rak|first2=Carl F.|title=Psychopharmacology for Mental Health Professionals: An Integrative Approach|publisher=Cengage Learning|isbn=9781305537231|url=https://books.google.de/books?id=KpyaBAAAQBAJ&pg=PA323|accessdate=18 May 2017|language=en}}</ref><ref>{{cite book|last1=Ph.D Vera Sonja|first1=Maass|title=Understanding Social Anxiety: A Recovery Guide for Sufferers, Family, and Friends|publisher=ABC-CLIO|isbn=9781440841965|url=https://books.google.de/books?id=W7P5DQAAQBAJ&pg=PA114|accessdate=18 May 2017|language=en}}</ref>

{{reflist talk|section}}

:Why do you think this content which is humanizing straight research is redundant?[[User:TracyMcClark|--TMCk]] ([[User talk:TracyMcClark|talk]]) 02:35, 19 May 2017 (UTC)