Editing MDMA (section)

===Recreational===
MDMA is often considered the drug of choice within the [[rave]] culture and is also used at clubs, festivals, and [[house party|house parties]].<ref name="pmid22392347" /> In the rave environment, the sensory effects of music and lighting are often highly [[Synergy|synergistic]] with the drug. The psychedelic [[amphetamine]] quality of MDMA offers multiple appealing aspects to users in the rave setting. Some users enjoy the feeling of mass communion from the inhibition-reducing effects of the drug, while others use it as party fuel because of the drug's stimulatory effects.<ref>{{cite book|vauthors=Reynolds S|title=Generation Ecstasy: Into the World of Techno and Rave Culture|year=1999|publisher=Routledge|isbn=978-0-415-92373-6|page=81|url=https://books.google.com/books?id=tGaRJiXe74UC&q=Generation+Ecstasy+MDMA&pg=PA81|access-date=13 October 2020|archive-date=8 November 2023|archive-url=https://web.archive.org/web/20231108064150/https://books.google.com/books?id=tGaRJiXe74UC&q=Generation+Ecstasy+MDMA&pg=PA81#v=snippet&q=Generation%20Ecstasy%20MDMA&f=false|url-status=live}}</ref> MDMA is used less often than other stimulants, typically less than once per week.<ref name=Epstein2013/>

MDMA is sometimes taken in conjunction with other psychoactive drugs such as [[LSD]],<ref name=":0">{{cite journal | vauthors = Zeifman RJ, Kettner H, Pagni BA, Mallard A, Roberts DE, Erritzoe D, Ross S, Carhart-Harris RL | title = Co-use of MDMA with psilocybin/LSD may buffer against challenging experiences and enhance positive experiences | journal = Scientific Reports | volume = 13 | issue = 1 | pages = 13645 | date = August 2023 | pmid = 37608057 | doi = 10.1038/s41598-023-40856-5 | pmc = 10444769 | bibcode = 2023NatSR..1313645Z }}</ref> [[psilocybin mushroom]]s, [[2C-B]], and [[ketamine]]. The combination with LSD is called "candy-flipping".<ref name=":0" /> The combination with 2C-B is called "nexus flipping". For this combination, most people take the MDMA first, wait until the peak is over, and then take the 2C-B.<ref>{{Cite web | vauthors = Weiss S |date=2024-02-16 |title=Nexus Flipping: What Happens When You Combine MDMA and 2C-B |url=https://doubleblindmag.com/nexus-flipping/ |access-date=2024-07-10 |website=DoubleBlind Mag |language=en-US}}</ref>

MDMA is often co-administered with [[Alcohol (drug)|alcohol]], [[methamphetamine]], and prescription drugs such as [[Selective serotonin reuptake inhibitor|SSRIs]] with which MDMA has several drug-drug interactions.<ref name="HysekSimmlerNicola2012">{{cite journal | vauthors = Hysek CM, Simmler LD, Nicola VG, Vischer N, Donzelli M, Krähenbühl S, Grouzmann E, Huwyler J, Hoener MC, Liechti ME | title = Duloxetine inhibits effects of MDMA ("ecstasy") in vitro and in humans in a randomized placebo-controlled laboratory study | journal = PLOS ONE | volume = 7 | issue = 5 | pages = e36476 | date = 2012-05-04 | pmid = 22574166 | doi = 10.1371/journal.pone.0036476 | pmc = 3344887 | bibcode = 2012PLoSO...736476H | veditors = Laks J | doi-access = free | quote = Fig. 7 shows the mean PD effects of MDMA plotted against simultaneous plasma concentrations at the different time points (hysteresis loops). The increases in “any drug effect" (Fig. 7a) and MAP (Fig. 7b) returned to baseline within 6 h when MDMA concentrations were still high. This clockwise hysteresis indicates that a smaller MDMA effect was seen at a given plasma concentration later in time, indicating rapid acute pharmacodynamic tolerance, which was similarly described for cocaine [33]. [...] Figure 7. Pharmacokinetic-pharmacodynamic (PK-PD) relationship. MDMA effects are plotted against simultaneous MDMA plasma concentrations (a, b). The time of sampling is noted next to each point in minutes or hours after MDMA administration. The clockwise hysteresis indicates acute tolerance to the effects of MDMA. }}</ref><ref>{{cite journal | vauthors = Yuki F, Rie I, Miki K, Mitsuhiro W, Naotaka K, Kenichiro N | title = Warning against co-administration of 3,4-methylenedioxymethamphetamine (MDMA) with methamphetamine from the perspective of pharmacokinetic and pharmacodynamic evaluations in rat brain | journal = European Journal of Pharmaceutical Sciences | volume = 49 | issue = 1 | pages = 57–64 | date = April 2013 | pmid = 23395913 | doi = 10.1016/j.ejps.2013.01.014 }}</ref><ref>{{cite journal | vauthors = Hamida SB, Tracqui A, de Vasconcelos AP, Szwarc E, Lazarus C, Kelche C, Jones BC, Cassel JC | title = Ethanol increases the distribution of MDMA to the rat brain: possible implications in the ethanol-induced potentiation of the psychostimulant effects of MDMA | journal = The International Journal of Neuropsychopharmacology | volume = 12 | issue = 6 | pages = 749–759 | date = July 2009 | pmid = 19046482 | doi = 10.1017/s1461145708009693 | s2cid = 24230367 | doi-access = free }}</ref> Three life-threatening reports of MDMA co-administration with [[ritonavir]] have been reported;<ref>{{cite journal | vauthors = Oesterheld JR, Armstrong SC, Cozza KL | title = Ecstasy: pharmacodynamic and pharmacokinetic interactions | journal = Psychosomatics | volume = 45 | issue = 1 | pages = 84–87 | date = 2004-03-01 | pmid = 14709765 | doi = 10.1176/appi.psy.45.1.84 | doi-access = free }}</ref> with ritonavir having severe and dangerous drug-drug interactions with a wide range of both psychoactive, anti-psychotic, and non-psychoactive drugs.<ref name="pmid31038898">{{cite journal | vauthors = Carpenter M, Berry H, Pelletier AL | title = Clinically Relevant Drug-Drug Interactions in Primary Care | journal = American Family Physician | volume = 99 | issue = 9 | pages = 558–564 | date = May 2019 | pmid = 31038898 | doi = }}</ref> <!--Users sometimes use [[menthol]]ated products while taking MDMA for its cooling sensation.{{Citation needed|date=October 2017}}-->