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Placebo is an activated item added in Afterbirth.
- Mimics the effect of Isaac's held pill, like Blank CardHas the same effect as the card or rune currently held by Isaac. does with cards or runes.
- Does not consume Isaac's held pill.
- Will not mimic cards or runes.
- 48 Hour Energy: Can be used to generate infinite batteries.
- Balls Of Steel: Grants 2 soul hearts (like the Blank CardHas the same effect as the card or rune currently held by Isaac. + The Hierophant synergy, except it adds them to your life rather than spawning them).
- Balls Of Steel + Sharp PlugUsing an activated item while it's not charged will charge it and Sharp Plug does 2 full heart damage to Isaac.: The player can gain functional invincibility.
- Little BaggyIsaac can hold 2 pills at once and all cards are replaced by pills.: Allows Isaac to hold one more pill than usual, giving the player a choice between two pill effects to copy.
- Mom's Bottle of PillsGives Isaac a random pill, and will cause him to drop any held Q-slot item (If any). The player will only receive six different pill types in one playthrough.: Allows Isaac to access different pills more quickly, but without the effects of an item like SchoolbagAllows Isaac to hold two active items., it's only useful for the floor on which both items have been found.
- Mom's Coin PurseSpawns 4 random pills around Isaac.: Gives Isaac several pills to use.
- VirgoGrants a chance to trigger the Book of Shadows effect upon taking damage, creating a shield that nullifies all types of damage for 10 seconds. Also converts "bad pills" into "good pills"., PHDConverts all bad pills into good pills, spawns one pill pickup and restores health. Identifies all pills upon pickup.: Pills will only have positive or neutral effects on Isaac.
- Power Pill: Works as a 4-room recharge version of The GamekidUpon use, turns the character into a into a Pac-Man-like creature for 5 seconds, granting invulnerability, inflicting fear on all enemies, and replenishing half a red heart container for every two enemies killed..
- Explosive Diarrhea: Spawns five bombs, making it useful for attacking or opening Secret Rooms.
- Friends Till The End!: Spawns 3 blue flies, similar to Guppy's HeadSpawns 2-4 blue flies to damage enemies..
- Hematemesis: Isaac will be set to one red heart and spawn 1-4 Red Heart pickups, which can be useful for Dark BumSpawns a familiar that follows Isaac around and collects red hearts. For every one-and-a-half red hearts collected, Dark Bum will generate one soul heart, one hostile Spider or one friendly blue spider. if the player has no red hearts.
- Stat-increasing pills:
- Range up: Increases range by 2.5 each use. With enough range, tears are fired high enough to travel over obstacles.
- Luck up: Increases luck by 1. With enough luck, this makes tear effects like Loki's HornsGives a random chance for projectiles to fire in all 4 cardinal directions. or Mom's ContactsAdds a chance to shoot petrifying tears, which stop enemies in place and prevent them from moving or attacking. Range up. certain or very likely to happen.
- This can actually have a negative effect on the game's randomness, as some Luck-based events are bugged, so an extremely high Luck stat renders them impossible to activate.
- One Makes You Smaller pill: Can be used to shrink repeatedly, making dodging enemies and hazards easier.
- I'm Drowsy...: Can be used repeatedly for instant Stop Watch Automatically inflicts slow to all enemies in every room.
Upon taking damage, inflicts slow to all enemies for the current room. effect without having to incur damage. This is very useful when fighting Hush and Delirium (especially as The Lost).
- Gulp!: Can be used as a 4-charge SmelterConsumes Isaac's currently held trinket and applies its effect permanently..
- Acid BabySpawns a familiar that drops random pills every 2 rooms cleared. Upon using a pill, all enemies in the room are poisoned.: Poisons enemies with every pill use. Also drops a pill occasionally.
- One Makes You Larger pill: Can be used to grow repeatedly, making dodging enemies and hazards more difficult.
- Starter DeckIsaac can hold 2 cards at once and all pills are replaced by cards.: All pills are replaced by cards, rendering Placebo useless.
- Placebo is a medicine or procedure prescribed for the psychological benefit to the patient rather than for any physiological effect.