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Acute Delirium

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A scepter was once created by the Lord of Eyes himself - the Daelkyr Price of Madness, Belashyrra. Who knows what power it holds?

Reign of Madness adpack icon.jpg
DDO Point icon.png Requires access to adventure pack: Reign of Madness
Acute Delirium
Heroic level: 17
Epic level: None
Duration: Long
Heroic XP:  ♣3,485Solo/Casual ♦6,036Normal ♥6,265Hard ♠6,493Elite
Epic XP: N/A
Takes place in: The Sleeping Spell Inn
Bestowed by: Rorry Malcanus
NPC contact: Rorry Malcanus
Quest acquired in: The Twelve
Patron: The Twelve
Base favor: 7
Free to Play: No
Extreme Challenge: No
M acute delirium.png
Loading screen


Rorry Malcanus, a lowly apprentice of the Twelve, decided to borrow the Scepter of Belashyrra and show it off to his girlfriend. Unfortunately this caused a portal to Xoriat to open while the pair were eating lunch at the local inn.

Go inside the Sleeping Spell Inn and retrieve the Scepter for Rorry.

Spoiler Warning: Information below this point can be considered spoiler material!


  • Retrieve Belashyrra's Sceptre
  • Assemble an airship to fly to Xoriat
    • 12 Beds
    • 6 Bookshelves
  • Use the Office ladder to gather aboard the airship
  • Force the beholder to vomit
  • Use Belashyrra's Sceptre to open a portal back to Eberron
  • (Optional) Keep the beholders from boarding the airship — Bonus (20%): Heroic( ♣697 ♦1,207 ♥1,253 ♠1,299 )
  • (Optional) Put Quixxellops out of his misery — Bonus (20%): Heroic( ♣697 ♦1,207 ♥1,253 ♠1,299 )

What to Expect

Tips and Misc

  • You can cast haste on the beds and bookshelves to make them move faster.
  • If you have not found the key under the beds you may let them die until you find it but make sure you have enough beds. If you have not found the chest behind the bookshelf you can use the same strategy.
    • If killed, the beds and bookshelves will respawn in their original location. They will be harder to kill the second time, due to their "experience in combat."
  • Enemies respawn MUCH more quickly on the Elite setting and can make soloing this quest a nightmare. The beds' and bookshelves' HP does not scale and they move very slowly even with Haste. The beds also move faster than the bookshelves and can eventually outrun them. It's recommended that you make 2 trips back and forth to assemble the ship: One convoy to bring all of the beds and a separate convoy to bring all of the bookshelves. Assign 3 to 4 people to clear the way forward while the rest of the party watches the rear.
  • Two fixes were put in with U16:
    • Beholders in the Airship portion of Acute Delirium now fall to their deaths properly if they are impaired before reaching the Airship.
    • Beholders in the Airship portion of Acute Delirium are no longer considered Extraplanar (due to being in Xoriat), and can no longer be banished.
  • Be careful when fighting the mimic, when you are in the beholder's stomach. It does more and more acid damage with each hit you do.
  • If you successfully identify the mimic in the beholder's stomach, it will drop keys to the other chests once it's defeated, but you can also just use Open Lock or Knock on those chests.
  • To "close the portal", use the scepter in the same room where you built the airship, then give the scepter to Belashyrra.

Bonus XP

  • Aggression bonus: ~80 or more monsters killed +10% Bonus.( ♣349 ♦604 ♥627 ♠649 )
  • Onslaught bonus: ~90 or more monsters killed +15% Bonus.( ♣523 ♦905 ♥940 ♠974 )
  • Conquest bonus: ~120 or more monsters killed +25% Bonus.( ♣871 ♦1,509 ♥1,566 ♠1,623 )
Notes: Note the amount of kills needed increases based on quest difficulty setting and the above figures are for elite. Getting as many kills listed should get you the bonuses on all difficulties, but will have lower totals needed on lower difficulties. Aggression is only around 65 on normal, but actually getting 65 or more kills on normal is also far more difficult, as the total monsters, and monster respawn rate is severely reduced.


  • Chests: Up to 7, 9 or 11 (depending on difficulty)
    • 1 after opening portal to Xoriat
    • 1 underwater in "unreachable" room, reached by jumping onto the walls in laundry room, near the shrines (accessible in Madness mode only). The "Imaginary Chest" can be accessed before handing over Sceptre.
    • The Lost Chest, needs the Lost Silver Key to open, which is under one of the beds, which need to be removed during the construction of the airship. Currently there is a Bug: that blocks access to opening the Secret door that would allow access to the room that contains the: Lost Chest, i.e. it's inaccessible.
    • 1 behind bookshelves after they are removed (must be looted before completing airship, as shelves reappear afterwards)
    • 1 if you successfully prevent the beholders from boarding the airship
    • Inside the Beholder's stomach, one lootable chest appears per difficulty level (1 for normal, 2 for hard, 3 for elite).
    • After the final fight, one chest appears per difficulty level (1 for normal, 2 for hard, 3 for elite).
  • NPC rewards: Standard, list of 4 items. Contains potions more frequently then other quests rewards.

Named Chest Drop

Last Edited Item Type Enhancements ML Bind Quests
  • Update 48.4.3
  • 1 year, 10 months, and 14 days
  • BugTime
Lenses of Opportunity
Lenses of Opportunity.png
Goggles  15 Bound to Account on AcquireIcon tooltip.pngBound to Account on Acquire: This item is Bound to Account on Acquire Acute Delirium, The Lost Chest
  • Update 48.4.2
  • 1 year, 10 months, and 17 days
  • BugTime
Watcher's Blade
Item Description Watchers Blade.png
Long Sword  16 Bound to Account on AcquireIcon tooltip.pngBound to Account on Acquire: This item is Bound to Account on Acquire Acute Delirium, End chest
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Name ( picture • New Monster ) CR Type Race
Armored Beholder( view
Armored Beholder.png
 • edit )
 ♠26Elite Aberration Beholder
Beholder Fleshmender( view
Beholder Fleshmender.png
 • edit )
 ♠25Elite Aberration Beholder
Beholder Priest( view
Beholder Priest.png
 • edit )
Aberration Beholder
Chaos Beholder( view
Chaos Beholder.png
 • edit )
 ♠23Elite Aberration Beholder
Chester( view
 • edit )
 ♦19Normal ♠29Elite Aberration Mimic
Deranged Follower( view
Deranged Follower.jpg
 • edit )
 ♦13Normal ♠18Elite Humanoid Human
Evil Eye( view
Evil Eye.png
 • edit )
 ♦12Normal ♠17Elite Aberration Evil Eye
Eye Horror( view
Eye Horror.png
 • edit )
 ♠21Elite Aberration Eye Horror
Frost Beholder( view
Frost Beholder.png
 • edit )
 ♥18Hard ♠21Elite Aberration Beholder
Ganglia( view
 • edit )
 ♠25Elite Aberration Beholder
Greater Evil Eye( view
Greater Evil Eye.png
 • edit )
 ♥17Hard ♠21Elite Aberration Evil Eye
Greater Thaarak Hound( view
Greater Thaarak Hound.png
 • edit )
 ♦15Normal ♥18Hard ♠21Elite Evil Outsider Hellhound
Haxxorrax( view
 • edit )
 ♦19Normal ♠29Elite Aberration Mind Flayer
Mind Flayer Mage( view
Mind Flayer Mage.png
 • edit )
 ♦16Normal ♥19Hard ♠23Elite Aberration Mind Flayer
Quixxellops( view
 • edit )
Aberration Beholder
Taken( view
 • edit )
 ♦13Normal ♥15Hard ♠18Elite Aberration Taken
Xorian Render( view
Xorian Render.jpg
 • edit )
 ♦15Normal ♥18Hard ♠21Elite Evil Outsider Demon
Young Beholder( view
Young Beholder.jpg
 • edit )
 ♦12Normal ♥14Hard ♠17Elite Aberration Beholder

Skill DCs