Abstract: Deaths due to the ring‐derivative amphetamines are not common and are usually accidental involving dehydration and hyperthermia. Suicides from 3,4‐methylenedioxymethamphetamine (MDMA) and related ring‐derivative amphetamines overdose are rare.
A 15‐year‐old female who had a history of depression and previous suicide attempts was found dead with a suicide note. Toxicology demonstrated lethal serum concentrations of MDMA (9.3 mg/L), with 34 mg/kg of MDMA in the liver, 2.4 mg/L in the urine, and 530 mg/kg
in the stomach. The cause of death was MDMA toxicity, the manner suicide. While MDMA may be detected in victims in other drug‐related or traumatic deaths, it is only rarely used in isolation in suicide, with a predominance in the 21‐ to 25‐year‐old range. Despite
the rarity of such events, the possibility of a nonaccidental manner of death should be considered when high levels of MDMA and associated amphetamines are found at autopsy.