Ecstasy overdose: How much amount of ecstasy to OD?

Is it true that partying too much can do you harm? When should you stop an ecstasy session? How does ecstasy overdose happen and why? What are the consequences of an ecstasy overdose? We review here and invite your questions about ecstasy overdose at the end.

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“Can ecstasy overdose occur?” you may be wondering. Absolutely.  In fact, ecstasy overdose is a preventable injury that has become an increasing public health concern. And while long term ecstasy effects on your brain may include serotonin related disorders, the short term effects can be pretty dangerous, as well.

But what complications can be present during overdose on ecstasy? What are the risks and how can you mitigate them? We review harm reduction for ecstasy users here. Then, we invite your questions about ecstasy or symptoms of ecstasy addiction at the end.

How does unintentional ecstasy overdose happen?

Ecstasy seriously effects serotonin, which is involved in mood, sleep and appetite. When on ecstasy, the brain triggers the release of serotonin, which causes the flood of good feelings, euphoria, greater sensitivity, desire for physical contact and intensified emotions. In this state, ecstasy users can lose touch with actual reality and go for another dose. So overdose can occur as the result of seeking further psychoactive effect.

Although the use of ecstasy alone can result in serious medical complications (including the need to get help for ecstasy addiction), its use in combination with other drugs can exacerbate acute dangers. Mixing “X” with other drugs or alcohol, users can think that the effects would be complementary. In fact, ecstasy is frequently taken with other recreational drugs such as marijuana, cocaine, or methamphetamine(s).

Further, as with most illegal drugs mainly sold on the streets, ecstasy users have to deal with the purity issue. In some instances, the synthetic drug PMA (paramethoxyamphetamine) has been sold as ecstasy. Because PMA’s hallucinogenic effects take longer to appear, users may consume too much of the drug, which can result in overdose death. Likewise, you may have heard of Molly, the street name for the pure MDMA powder (the main chemical in ecstasy). Molly has become a part of the popular culture. However, overdoses are registered at big electronic music festivals in USA.

Ecstasy overdose – How much is too much?

Typical doses of ecstasy in a series of pills can range between 10–150 mg. Some users have reported taking doses of up to 700 mg of ecstasy in a session. The most common pattern of use is binge consumption at all night rave or dance parties. However, the upper limit for an ecstasy dose is not more than 1.5–1.8 mg MDMA/kg body weight because of possible long-term damages to an important region of the brain.

Ecstasy overdose complications

Upon ecstasy overdose, the potentially serious serotonin syndrome, stimulant psychosis, and hypertensive crisis, among other dangerous adverse reactions, may occur. The symptoms of of ecstasy overdose can include:

Psychological symptoms

  • agitation, restlessness and paranoia
  • cognitive and memory impairment and amnesia
  • disorientation and confusion
  • hallucinations and delusions
  • thought disorder or disorganized thinking

Physiological symptoms

  • cardiac dysfunction, arrest and heart failure
  • coma or death
  • convulsions
  • damage to the heart
  • destruction of blood vessels
  • hemorrhage and stroke
  • hyperactivity
  • hyper reflexia
  • hypertension or hypotension
  • loss of consciousness
  • muscle rigidity
  • palpitations
  • rapid breathing and shortness of breath
  • renal failure
  • severe chest pain
  • severe hyperthermia, potentially resulting in organ failure
  • tachycardia

Ecstasy overdose prognosis

Ecstasy is a worldwide recreational drug of abuse. Unfortunately, research results don’t provide much good news in terms of long term prognosis after overdose or chronic abuse of ecstasy. When comparing present ecstasy users with past users (after a period of abstinence of 4 or more years), past ecstasy users don’t show many signs of recovery; evidence of prolonged impairment to the memory and clinically significant levels of depression, impulsiveness, and sleep disturbance can persist, even after a period of abstinence.

Ecstasy overdose death rate

More than one third of ecstasy-related emergency room (ER) visits were made in the South of the U.S. recently. Over 22,500 visits were made due to ecstasy overdose and concurrent drug use. That is an estimated increase of over 100% compared with 10 years ago. The number of ER visits made by patients aged 20 or younger is twice the number of patients aged 21 or older.

What is alarming is that more than 40% of the total number of emergency room visits for overdose are fatalities. The most common cause of death were raised body temperatures, acute liver failure, cardiac arrest, brain seizure and uncontrolled bleeding through multiple sites.

Ecstasy overdose amount questions

In case you have any more questions, you are welcome to post them in the comments section below. We will try to provide you with a prompt and personal answer ASAP.

Reference sources: National Highway Traffic Safety Administration: MDMA
The U.S. Department of Justice: MDMA(Ecstasy) Fast Facts
Substance Abuse and Mental Health Services Administration:Ecstasy
Centers for Disease and Control Prevention: Morbidity and Mortality Report
National Institute of Health Medical Trials
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.


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  1. Can you point me to any additional studies on Neurotoxicity from MDMA?
    Studies on safe / unsafe dosages?
    Any dosing protocols, predominately related to safety?

    Thank you!

    1. Hi Drew. There are no safe dosages when your are taking illicit drugs. I did research on Google using these keywords ‘ Neurotoxicity from MDMA’, and found some interesting studies:
      You can do the same.

  2. Amazing to actually know what this type of drug can do to you, even when its known for a little rave or a minor pill but i’m going to swallow and take them anyway because no one can suggest a suffice way of getting your mind off things ayy well thats no question BUT THANK YOU ALL, FOR THE TIME I HAVE WASTED AND PEACE ALSO PILLS HAVE BEEN CREATED TO MANKIND FOR AMAZING EXPERIENCE, SO YALL DONT RUIN IT NOW FOR THE SECOND TIME PEACEE .

  3. Okay this has been bothering me for a little more than a month now. Im okay [knock on wood] but need closure. I took a .2 of molly. Im 100 pounds It was great until the end obviously. There was a hottub and i kept staying hydrated and everything was fine till the end. My symptoms were the i dont care attitude, rapid heart beat, inability to fall asleep, confusion, constant talking, and severe fatigue. The roll was about 7 hours.but when it was done i still felt it a little yet got these symptoms. HOWEVER I didnt eat anything and worked out that day. Do you think it was low blood sugar that made me that way? Bc its very posttramatic to me. The anxiety lasted for hours and i was still numb from the drug. I got anxiety from thinking too hard while rolling which made me freak out. I definitly took more than i should of but did the not eating and cardio workout be the reason my bofy got the wayit did? Thanks!

  4. I’m worried for my friends for they use E time to time at raves and they seem fine after the come down, they are depressed and a little off. Again this is only on big events that happen every other month or so, taking about 2-3 pills a night of said events. Is that too much? Obviously they shouldn’t do it but is this amount considered “too much”? Are they doomed for permanent damage to the brain or are they always going to be this depressed if they continue to use it with months in between? How much use is “too much” even though they shouldn’t do it? Example, they use 1-3 pills a night, once a month, every other month. Is that considered “too much” use?

  5. I haven’t encountered anybody overdosing on Ecstasy although I’ve seen a lot of people having problems encountered with taking adulterated ecstasy pills where they don’t know what they have been mixed with or even if the pill contains any MDMA at all. It would be great to see government or privately funded testing like they do in Europe to prevent injuries or deaths due to bad pills as I don’t envision a total stop to ecstasy use anytime soon and the laws regarding drug use are draconian and simply push young people to take bigger risks.

  6. After how many hours or days would you say it’s okay to sleep safely with no worries? & if ecstasy may have caused the big part under your tumb on your plam to swell but then kinda went down but still a bump their, is it okay to say it will go away by its self .?

    1. Hello Samuel. Are you sure that ecstasy is the reason for the swelling of your palm? Maybe, you hit yourself, and you don’t remember. However, ecstasy can be detected up to two days.

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