System	
  Reference	
   Document	
  5.1 	
   201	
  
Madness 
In	
  a	
  typical	
  campaign,	
  characters	
  aren’t	
  driven	
  mad	
  
by	
  the	
  horrors	
  they	
  face	
  and	
   the	
  carnage	
  they	
  inflict	
  
day	
  after	
  day,	
  but	
  sometimes	
  the	
  stress	
  of	
  being	
  an	
  
adventurer	
  can	
  be	
  too	
  much	
  to	
  bear.	
  If	
  your	
  
campaign	
  has	
  a	
  strong	
  horror	
  theme,	
  you	
  might	
  
want	
  to	
  use	
  madness	
  as	
  a	
  way	
  to	
  reinforce	
  that	
  
theme,	
  emphasizing	
  the	
  extraordinarily	
  hor rific	
  
nature	
  of	
  the	
  threats	
  the	
  adventurers	
  face. 	
  
Going Mad 
Various	
  magical	
  effects	
  can	
  inflict	
  madness	
  on	
  an	
  
otherwise	
  stable	
  mind.	
  Certain	
  spells,	
  such	
  as	
  
contact	
  other	
  plane 	
  and	
  symbol,	
  can	
  cause	
  insanity,	
  
and	
  you	
  can	
  use	
  the	
  madness	
  rules	
  here	
  instead	
   of	
  
the	
  spell	
  effects	
  of	
  those	
  spells .	
  Diseases,	
  poisons,	
  
and	
  planar	
  effects	
  such	
  as	
  psychic	
  wind	
  or	
  the	
  
howling	
  winds	
  of	
  Pandemonium	
  can	
  all	
  inflict	
  
madness.	
  Some	
  artifacts	
  can	
  also	
  break	
  the	
  psyche	
  of	
  
a	
  character	
  who	
  uses	
  or	
  becomes	
  attuned	
  to	
  them. 	
  
	
   Resisting	
  a	
  madness -­‐‑inducing	
  effect	
  usually	
  
requires	
  a	
  Wisdom	
  or	
  Charisma	
  saving	
  throw. 	
  
Madness Effects 
Madness	
  can	
  be	
  short -­‐‑term,	
  long-­‐‑term,	
  or	
  indefinite.	
  
Most	
  relatively	
  mundane	
  effects	
  impose	
  short -­‐‑term	
  
madness,	
  which	
  lasts	
  for	
  just	
  a	
  few	
  minutes.	
  More	
  
horrific	
  effects	
  or	
  cumulative	
  effects	
  can	
  result	
  in	
  
long-­‐‑term	
  or	
  indefinite	
  madness. 	
  
	
   A	
  character	
  afflicted	
  with	
   short-­‐‑term	
  madness 	
  is	
  
subjected	
  to	
  an	
  effect	
  from	
  the	
  Short -­‐‑Term	
  Madness	
  
table	
  for	
  1d10	
  minutes. 	
  
	
   A	
  character	
  afflicted	
  with	
   long-­‐‑term	
  madness 	
  is	
  
subjected	
  to	
  an	
  effect	
  from	
  the	
  Long -­‐‑Term	
  Madness	
  
table	
  for	
  1d10	
  ×	
  10	
  hours. 	
  
	
   A	
  character	
  afflicted	
  with	
   indefinite	
  madness 	
  
gains	
  a	
  new	
  character	
  flaw	
  from	
  the	
  Indefinite	
  
Madness	
  table	
  that	
  lasts	
  until	
  cured. 	
  
Short-­‐Term	
  Madness	
  
d100	
   Effect	
  (lasts	
  1d10	
  min utes)	
  
01–20	
   The	
  character	
  retreats	
  into	
  his	
  or	
  her	
  mind	
  and	
  
becomes	
  paralyzed.	
  The	
  effect	
  ends	
  if	
  the	
  
character	
  takes	
  any	
  damage. 	
  
21–30	
   The	
  character	
  becomes	
  incapacitated	
  and	
  
spends	
  the	
  duration	
  screaming,	
  laughing,	
  or	
  
weeping.	
  
31–40	
   The	
  character	
  becomes	
  frightened	
  and	
  must	
  
use	
  his	
  or	
  her	
  action	
  and	
  movement	
  each	
  
round	
  to	
  flee	
  from	
  the	
  source	
  of	
  the	
  fear. 	
  
41–50	
   The	
  character	
  begins	
  babbling	
  and	
  is	
  incapable	
  
of	
  normal	
  speech	
  or	
  spellcasting. 	
  
51–60	
   The	
  character	
  must	
  use	
  his	
  or	
  her	
  action	
  each	
  
round	
  to	
  attack	
  the	
  nearest	
  creature. 	
  
61–70	
   The	
  character	
  experiences	
  vivid	
  hallucinations	
  
and	
  has	
  disadvantage	
  on	
  ability	
  checks. 	
  
71–75	
   The	
  character	
  does	
  whatever	
  anyone	
  tells	
  him	
  
or	
  her	
  to	
  do	
  that	
  isn’t	
  obviously	
  self -­‐
destructive.	
  
76–80	
   The	
  character	
  experiences	
  an	
  overpowering	
  
urge	
  to	
  eat	
  something	
  strange	
  such	
  as	
  dirt,	
  
slime,	
  or	
  offal.	
  
81–90	
   The	
  character	
  is	
  stunned. 	
  
91–100	
   The	
  character	
  falls	
  unconscious. 	
  
Long-­‐Term	
  Madness	
  
d100	
   Effect	
  (lasts	
  1d10	
  ×	
  10	
  hours) 	
  
01–10	
   The	
  character	
  feels	
  compelled	
   to	
  repeat	
  a	
  
specific	
  activity	
  over	
  and	
  over,	
  such	
  as	
  washing	
  
hands,	
  touching	
  things,	
  praying,	
  or	
  counting	
  
coins.	
  
11–20	
   The	
  character	
  experiences	
  vivid	
  hallucinations	
  
and	
  has	
  disadvantage	
  on	
  ability	
  checks. 	
  
21–30	
   The	
  character	
  suffers	
  extreme	
  paranoia.	
  Th e	
  
character	
  has	
  disadvantage	
  on	
  Wisdom	
  and	
  
Charisma	
  checks.	
  
31–40	
   The	
  character	
  regards	
  something	
  (usually	
  the	
  
source	
  of	
  madness)	
  with	
  intense	
  revulsion,	
  as	
  if	
  
affected	
  by	
  the	
  antipathy	
  effect	
  of	
  the	
  
antipathy/sympathy	
  spell. 	
  
41–45	
   The	
  character	
  experiences	
  a	
  powerful	
  delusion.	
  
Choose	
  a	
  potion.	
  The	
  character	
  imagines	
  that	
  
he	
  or	
  she	
  is	
  under	
  its	
  effects. 	
  
46–55	
   The	
  character	
  becomes	
  attached	
  to	
  a	
  “lucky	
  
charm,”	
  such	
  as	
  a	
  person	
  or	
  an	
  object,	
  and	
  has	
  
disadvantage	
  on	
  attack	
  rolls,	
  ability	
  checks,	
  and 	
  
saving	
  throws	
  while	
  more	
  than	
  30	
  feet	
  from	
  it. 	
  
56–65	
   The	
  character	
  is	
  blinded	
  (25%)	
  or	
  deafened	
  
(75%).	
  
66–75	
   The	
  character	
  experiences	
  uncontrollable	
  
tremors	
  or	
  tics,	
  which	
  impose	
  disadvantage	
  on	
  
attack	
  rolls,	
  ability	
  checks,	
  and	
  saving	
  throws	
  
that	
  involve	
  Strength	
  or	
  Dexterity. 	
  
76–85	
   The	
  character	
  suffers	
  from	
  partial	
  amnesia.	
  The	
  
character	
  knows	
  who	
  he	
  or	
  she	
  is	
  and	
  retains	
  
racial	
  traits	
  and	
  class	
  features,	
  but	
  doesn’t	
  
recognize	
  other	
  people	
  or	
  remember	
  anything	
  
that	
  happened	
  before	
  the	
  madness	
  took	
  e ffect.	
  
86–90	
   Whenever	
  the	
  character	
  takes	
  damage,	
  he	
  or	
  
she	
  must	
  succeed	
  on	
  a	
  DC	
  15	
  Wisdom	
  saving	
  
throw	
  or	
  be	
  affected	
  as	
  though	
  he	
  or	
  she	
  failed	
  
a	
  saving	
  throw	
  against	
  the	
  confusion	
  spell.	
  The	
  
confusion	
  effect	
  lasts	
  for	
  1	
  minute. 	
  
91–95	
   The	
  character	
  loses	
  the	
  ability	
  to	
  speak.	
  
96–100	
   The	
  character	
  falls	
  unconscious.	
  No	
  amount	
  of	
  
jostling	
  or	
  damage	
  can	
  wake	
  the	
  character. 	
  