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Does anyone besides Doc James think it's a bad idea to cover each significant topic only once in the lead, or should we keep the coverage of medical use scattered and make the 1st and 4th lead paragraphs redundant? Seppi333 (Insert 2¢) 17:16, 28 September 2017 (UTC)[reply]

One is medical uses, the other is research. They are two separate topics and generally we keep them as two separate topics. It is a ongoing problem that people try to position tentative research as confirmed medical uses. Doc James (talk · contribs · email) 17:20, 28 September 2017 (UTC)[reply]

The 4th paragraph is discussing an expedited drug approval process which would result in an MDMA having an "accepted medical use". That's not research. Seppi333 (Insert 2¢) 17:24, 28 September 2017 (UTC)[reply]

That is an early step "setting it on a fast track for review and potential approval" per [1] That is NOT approval. There is always a lot of hype around research. We need to keep that separate from the more sedate world of actual medical uses or the lack of such as it is easy to have the hype around research mislead people.

If / when it is approved by the FDA, that will be a big deal and would than belong in the first paragraph as a medical use. Doc James (talk · contribs · email) 17:29, 28 September 2017 (UTC)[reply]

The two topics are connected though. It would only occur to the reader that MDMA might have medical use after being informed of its past use by therapists and the current clinical trials. We jump the gun by placing this information in the first paragraph. The medical use of a substance is a notable fact. The lack of medical use of a substance is not by itself notable because most substances do not have medical uses. It is only becomes a notable fact within a context that would lead the reader to believe it might have medical uses. Sizeofint (talk) 20:18, 28 September 2017 (UTC)[reply]

Re: what Sizeofint said. Seppi333 (Insert 2¢) 21:41, 28 September 2017 (UTC)[reply]

We could have a RfC I guess. Doc James (talk · contribs · email) 06:06, 29 September 2017 (UTC)[reply]

Sure. Options are to move para 4 above the current paragraph 2, move that sentence about medical use to the end of para 4, or keep it as is. Seppi333 (Insert 2¢) 17:41, 29 September 2017 (UTC)[reply]

• I would rather keep it as is. The sentence about medical use essentially functions as a clarification for the first sentence, which defines MDMA as a recreational drug. I imagine that the thought process of the first-time reader goes: while it may be used for recreational purposes, it has not been officially recognized for having any medicinal purposes (indications). ―Biochemistry🙴❤ 23:27, 4 October 2017 (UTC)[reply]

*Agree with Doc James; Keep 'recreational drug' and 'no medical use' in lead, keep the application to conduct a research study below. Rgr09 (talk) 00:48, 5 October 2017 (UTC)[reply]

• agree w/ Rgr09--Ozzie10aaaa (talk) 10:45, 5 October 2017 (UTC)[reply]

I would much rather have us initially set the scene for MDMA by explaining to readers that it's a recreational drug that has no medical uses. We have sources that support that on world-wide scale. It's on Schedule 1 of the United Nations Convention on Psychotropic Substances. Having research on its possible use against PTSD fast-tracked by the US FDA is an interesting fact in one country. It doesn't mean that the rest of the world is going to ignore the UN Convention, so there's still a long way to go before there's any possible legitimate medical use in sight. Much as the stoners would like our article to focus the slim possibility that one day, at some indeterminate point in the future, a putative medical use may be found and approved somewhere, the fact is that there is no accepted medical use right now, and Wikipedia is not a crystal ball. --RexxS (talk) 22:29, 5 October 2017 (UTC)[reply]

@Ozzie10aaaa, Rgr09, Biochemistry&Love, and RexxS: Just to be clear, this section isn't about moving the medical uses sentence down or removing it; it's about moving the current 4th lead paragraph above the current 2nd lead paragraph, since this is what Doc James reverted: edit–revert. In other words, the lead of the article would look like this instead of how it currently appears. This wasn't made clear in this section and it doesn't appear, based upon your responses, that you were aware of this. So, what are your thoughts on moving this paragraph? Seppi333 (Insert 2¢) 22:32, 5 October 2017 (UTC)[reply]

I'm having trouble seeing why this really makes a difference. --Tryptofish (talk) 22:44, 5 October 2017 (UTC)[reply]

(edit conflict) @Seppi333: Normally our leads summarise the content of the article in approximately the same order as the sections in the body of the article. It would be unusual to bring the research paragraph above the effects and uses paragraphs as it would – to me, at least – imply a greater importance for research to the reader than the topics of effects and usage. I haven't seen any case made that an unusual prioritisation is appropriate here. I'm pretty sure I have a slight preference for the "definitions" - "effects" - "usage" - "research" order over the alternative suggested. --RexxS (talk) 22:45, 5 October 2017 (UTC)[reply]

The history of the article is somewhat more complicated than I had realized. After looking at some of the issues that have arisen on the talk page in the past, I think the current lead structure, as described by RexxS, is preferable. I haven't yet found a category for 'recreational drugs', perhaps that could be considered? The closest thing is the article Recreational drug use. I don't see, however, that it lists 'hundreds' of articles on this subject. Rgr09 (talk) 01:02, 8 October 2017 (UTC)[reply]

@Seppi333: Thank you for the clarification! I agree with RexxS's conclusions. After reviewing the change, it doesn't make much sense to me to have the research placed in precedence to the effects. While the respective sections within the page could be moved as well, I think that moving the research section to the proposed place seems out of place.―Biochemistry🙴❤ 15:53, 8 October 2017 (UTC)[reply]

I vote for keeping it as is. (Since the lede is protected, I assume it will not change anytime soon, but just in case, I read the article as of the 14:28, 8 October 2017 revision.)

I suggest adding an endnote to the last sentence of the lede's 4th paragraph:

MDMA was granted breakthrough therapy designation by the FDA [endnote] for PTSD in August 2017.

Where the endnote would be a copy of, or very similar to, this sentence from the Breakthrough therapy article: "The FDA acknowledges that this designation is not intended to imply that the drug is actually a "breakthrough".[3] It allows the FDA to grant priority review to drug candidates if preliminary clinical trials indicate that the therapy may offer substantial treatment advantages over existing options for patients with serious or life-threatening diseases.[4][5][6]".

I realize that readers can click on the link to the Breakthrough therapy article, but how many will do that compared to how many will read the endnote? I don't know for sure, but I suspect that the endnote will garner more attention and alert at least some visitors to the (counterintuitive) meaning of "breakthrough therapy".   - Mark D Worthen PsyD (talk) 07:03, 9 October 2017 (UTC)[reply]

I've added the note that you suggested. Seppi333 (Insert 2¢) 08:41, 9 October 2017 (UTC)[reply]

Thank you Seppi333. :O) ... I really like how you phrased it, complete with footnotes.   - Mark D Worthen PsyD (talk) 08:14, 11 October 2017 (UTC)[reply]

No problem. Thanks for suggesting it; it was a useful clarification IMO. Seppi333 (Insert 2¢) 21:18, 3 November 2017 (UTC)[reply]

It says "The duration of action of MDMA is usually four to six hours, after which serotonin levels in the brain are depleted." citing https://www.ncbi.nlm.nih.gov/pubmed/27859780

This makes it sound as though serotonin levels were entirely depleted, which is not the case. It might even be understood as saying that the duration would be even longer, but is halted due to total serotonin depletion.

The source actually says: "The mean duration of action is 4–6 h, followed by a regeneration phase with substantial serotonin depletion" — Preceding unsigned comment added by 88.66.247.169 (talk) 18:26, 12 November 2017 (UTC)[reply]

Generally go after uses. Thus restored prior order. Doc James (talk · contribs · email) 21:17, 8 December 2017 (UTC)[reply]

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Several sentences in this article say "As of 2017 ..." and I ran across the following article which indicates that the research status of MDMA is changing. I do not understand medical terminology much so maybe some who does can use this article as appropriate.

• https://theconversation.com/is-psychiatry-ready-for-medical-mdma-94105

172.88.134.103 (talk) 11:14, 31 March 2018 (UTC)[reply]

We would need sources as outline at WP:MEDRS

Yes MDMA is being studied but is far from approved. Doc James (talk · contribs · email) 00:37, 1 April 2018 (UTC)[reply]

I certainly understand the need for specialized sources, but surely if the FDA altered the drug's technical designation and approved it for special clinical studies those are significant facts that should be part of the article, yes? A quick Google search for [MDMA FDA "breakthrough therapy designation"] resulted in over 30,000 hits including numerous substantial articles in the Wall Street Journal, Forbes, and the FDA website itself just to name a few. I also see numerous medical publications on this matter but am unaware which of them are considered reliable sources. Obviously these studies have not yet come to conclusion but the article should reflect any substantial changes in the current state of affairs I would think. 172.88.134.103 (talk) 06:21, 23 April 2018 (UTC)[reply]

I don't think the history segment of this article should be placed as far into the article as it is. I think it's an important enough detail to be placed as the first subtopic of the article. I am amazed as to why it is as far into the topic as it is.

23:52, 22 February 2019 (UTC)