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In the Sanity Rules it states:

A single casting of lesser restoration reduces sanity damage by 1d2 points up to once per day;

Further down in the madness section it states:

Certain spells can also aid in recovery from madnesses or cure them outright. Lesser restoration has no effect on greater madnesses, but reduces the current DC of one lesser madness afflicting the target by 2, up to once per day.

Do we get both effects from a single cast? It seems really unclear.

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Based on the wording of the rules I would say Yes, you get both effects from a single cast.

Under normal circumstances a single cast of a Restoration spell (or the Lesser/Greater variants) can dispel harmful magical effects or cure ability damage but it will still eliminate fatigue regardless of which you choose.

Since the rules on sanity do not explicitly say you must choose to cure sanity damage or reduce the DC I would interpret that you receive both beneficial effects, as well as the normal effects of the spell.


Sanity is an optional rule and you (or your GM) will need to decide to what degree it is implemented and how oppressive it will be. If you play with these rules and find that it makes restoring sanity damage and madnesses too easy, you can always tweak it for your own campaign.

If you read the Sidebars on the Sanity rules page they give you some ideas for possible tweaks that can be made to the system in order to customize it for your game.

For example:

In a particularly horror-themed game, the GM may consider removing some or all of the magical options to reduce sanity damage, relying on rest alone to recover sanity.

or:

If you want to feature the madnesses as afflictions that are simple to remove for high-level spellcasters while outside the reach of anyone else—as per the more baseline experience—assume lesser madnesses are not affected by lesser restoration, and greater restoration, heal, and psychic surgery remove all madnesses, whether lesser or greater.

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    \$\begingroup\$ When reading the book, there is a lot of back and forth referencing between the two systems, which might even cause confusion at first. But its entirely possible to use one system without the other. \$\endgroup\$ – ShadowKras Oct 18 '17 at 10:51
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    \$\begingroup\$ @ShadowKras I didn't want to spend too much time in the second half of my answer prattling on about optional rules since the crux of the question was about Restoration interacting with both features. If you think mentioning that madness and sanity can be used separately would improve the answer then I could add that in. \$\endgroup\$ – GreedyRadish Oct 18 '17 at 10:55
  • \$\begingroup\$ I think you have it right, though I think it would be nice to get some different perspectives. It certainly doesn't explicitly mention an either or effect. \$\endgroup\$ – Tacgnol Oct 18 '17 at 11:21
  • \$\begingroup\$ @GreedyRadish I was going to write an answer from that perspective, but I realized it was looking too similar to yours and not worth repeating what was already said. If I had to guess, two different authors wrote the two systems, and later the editor connected the dots. I like the result, but it would benefit greatly if they weren't separated from each other by nearly 100 pages. \$\endgroup\$ – ShadowKras Oct 18 '17 at 13:34
  • \$\begingroup\$ @Tacgnol I appreciate you accepting my answer, but in the future you may wish to leave the question open for a few more days just to see if any other answers pop up. Anyway, welcome to the site! Be sure to take the tour. \$\endgroup\$ – GreedyRadish Oct 18 '17 at 21:22

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