Keeper of Madness

Medium aberration, lawful evil

Armor Class 16 (chainmail)
Hit Points 84 (13d8 + 26)
Speed 30 ft

10 (+0) 10 (+0) 14 (+2) 20 (+5) 16 (+3) 16 (+3)

Saving Throws Int +8, Wis +6, Cha +6
Skills Arcana +8, Deception +6, Insight +6, Investigation +6, Perception +6, Persuasion +6
Condition Immunities charmed
Senses darkvision 120 ft., passive Perception 16
Languages Common, Deep Speech, Undercommon, telepathy 120 ft.

Challenge 8 (3,900 XP)


  • Extraplanar Salvation. If damage reduces the keeper of madness to 0 hit points, it may attempt an Intelligence saving throw with a DC of 5 + the damage taken. On a success, the keeper of madness drops to 1 hit point and can use its reaction to cast plane shift on itself, traveling to a location of its choice on another plane of existence. This casting of plane shift can be negated by counterspell and any other effects that interfere with casting a spell.
  • Magic Resistance. The keeper of madness has advantage on saving throws against spells and other magical effects.
  • Innate Spellcasting. The keeper of madness is a 10th-level spellcaster. Its spellcasting ability is Intelligence (spell save DC 16, +8 to hit with spell attacks). The keeper of madness can cast the following spells innately, requiring no material components:


  • Mental Breakdown. Melee Weapon Attack: +7 to hit, reach 5 ft., one stunned creature. Hit: The target takes 55 (10d10) psychic damage; if this damage reduces the target to 0 hit points, the target remains unconscious for 1d4 hours, regardless of any healing received. When the target awakens, it is afflicted by madness, giving it disadvantage on all ability checks and saving throws with Intelligence, Wisdom, or Charisma. The target also gains the following flaw: “I never feel safe, not even in my thoughts.” This effect is considered a curse, and can be removed by any effects that remove curses.
  • Touch of Insanity. Melee Weapon Attack: +7 to hit, reach 5 ft., one target. Hit: 15 (2d10 + 4) psychic damage. If the target is a humanoid, it must succeed on a DC 16 Intelligence saving throw or become stunned. Stunned creatures can repeat the saving throw at the end of each of their turns, ending the effect on a success. Lesser restoration or similar, more powerful spells will also remove this effect.
  • Wave of Madness (Recharge 6). The keeper of madness magically projects a cone 60 feet in length. Each creature in the area must attempt a DC 16 Wisdom saving throw, taking 36 (8d8) psychic damage on a failure and gaining one random effect from the Madness: Short-Term table. On a success, the damage is halved and the target does not go mad. This is considered a charm effect.
Madness Effects: Short-Term
d% Effect (lasts 1d10 minutes)
01-20 The creature retreats into its mind and becomes paralyzed. The effect ends if the creature takes any damage.
21-30 The creature becomes incapacitated and spends the duration screaming, laughing, or weeping.
31-40 The creature becomes frightened and must use its action and movement each round to flee from the source of the fear.
41-50 The creature begins babbling and is incapable of normal speech or spellcasting.
51-60 The creature must use its action each round to attack the nearest creature.
61-70 The creature experiences vivid hallucinations and has disadvantage on ability checks.
71-75 The creature does whatever anyone tells it to do that isn’t obviously self-destructive.
76-80 The creature experiences an overpowering urge to eat something strange such as dirt, slime, or offal.
81-90 The creature is stunned.
91-100 The creature falls unconscious.
Madness Effects: Emotional Manipulation
d4 Emotion Stage One Stage Two Stage Three
1 Fear Flaw: “One of my friends is trying to kill me.” Bond: “I must convince the rest of my friends that one of them is not to be trusted. I need them on my side.” Bond: “The traitor knows. I must stop the traitor before I’m killed, by any means necessary.”
2 Sadness Ideal: “Opening up and sharing strengthens friendships. I should share my sorrows with my closest friends.” Bond: “This curious floating stone makes me feel at ease. Nothing else does. I should remain near it.” Flaw: “Anyone who tries to cheer me up just can’t see the truth. I must convince them the world is terrible.”
3 Anger Flaw: “Everything is an insult; some are just hidden behind false kindness.” Bond: “I’m going to punch the next person who disagrees with me.” Ideal: “Every dispute should be settled with violence. Last one conscious must be right.”
4 Happiness Ideal: “Good things come to those who wait! Why struggle when things will work themselves out?” Flaw: “I can’t get worked up about anything, not even a good cause. I’m always happy with the ways things are.” Flaw: “Anyone who tries to make me sad is a terrible villain. I should punish them for trying to steal the most precious thing.”
Madness Effects: Long-Term
d% Effect (Lasts 1d10 X 10 Hours)
01-10 The creature feels compelled to repeat a specific activity over and over, such as washing hands, touching things, praying, or counting coins.
11-20 The creature experiences vivid hallucinations and has disadvantage on ability checks.
21-30 The creature suffers extreme paranoia and has disadvantage on Wisdom and Charisma ability checks.
31-40 The creature 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 creature experiences a powerful delusion. Choose a potion. The creature imagines that it is under its effects.
46-55 The creature 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 ft. from it.
56-65 The creature is blinded (25%) or deafened (75%).
66-75 The creature experiences uncontrollable tremors or tics, which impose disadvantage on attack rolls, ability checks, and saving throws that involve Strength or Dexterity.
76-85 The creature suffers from partial amnesia. It knows who it is and retains racial traits and class features, but it doesn’t recognize other people or remember anything that happened before the madness took effect.
86-90 Whenever the creature takes damage, it must succeed on a DC 15 Wisdom saving throw or be affected as though it failed a saving throw against the confusion spell. The confusion effect lasts for 1 minute.
91-95 The creature loses the ability to speak.
96-100 The creature falls unconscious, and no amount of jostling or damage can wake it.
Madness Effects: Indefinite
d% Flaw (Lasts Until Cured)
01-15 “Being drunk keeps me sane.”
16-25 “I keep whatever I find.”
26-30 “I must become more like someone else I know, adopting that person’s style of dress, mannerisms, and name.”
31-35 “I must bend the truth, exaggerate, or outright lie to be interesting to other people.”
36-45 “Achieving my goal is the only thing of interest to me, and I’ll ignore everything else to pursue it.”
46-50 “I find it hard to care about anything that goes on around me.”
51-55 “I don’t like the way people judge me all the time.”
56-70 “I am the smartest, wisest, fastest, and most beautiful person I know.”
71-80 “I am convinced that powerful enemies are hunting me, and their agents are everywhere I go. I am sure they’re watching me all the time.”
81-85 “There’s only one person I can trust. And only I can see this special friend.”
86-95 “I can’t take anything seriously. The more serious the situation, the funnier I find it.”
96-100 “I’ve discovered that I really like killing people.”
Section 15: Copyright Notice

Total Party Kill Handbook - Volume 1 2019 © 2CGaming, LLC. Author Steven Gordon

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