Adrenaline

Item Icon
Pickup Quote	"Panic = power"
Entity ID	5.100.493
Item Pool	Devil Beggar Treasure Room Treasure Room
Quality	1
Item Tags
Collection Grid	(page 5, column 8, row 1) (page 5, column 9, row 1)

Adrenaline is a passive item added in The Binding of Isaac: Afterbirth †.

Effects

• Gives Isaac a flat damage up based on how many empty Heart containers he has.
  • The damage up given is 0.2 for each empty Red Heart container Isaac has.
    • The damage up given is ((2 × MissingHearts) ^ 1.6) × 0.1, where MissingHearts is the number of full red hearts of health missing. The amount of damage gained this way is exponential, so each heart lost will provide a bigger bonus than the last.
  • Damage ups are only applied for every fully empty heart container.
• This item belongs to the Spun set. Collecting three items from this set will transform Isaac into a buff berserker.

Notes

• This item has no effect on characters that can't have any Red Heart containers, unless Bone Hearts are collected. If a Bone Heart is gone, so does the Adrenaline damage. This means that Adrenaline is only truly useless on The Lost.
• This item affects both Keeper and Tainted Keeper; empty Coin Hearts increase damage.
• As The Forgotten, empty Bone Hearts increase damage, but if the Bone Hearts are broken, the damage buff is lost.
• The maximum damage bonus from Adrenaline is 14.05 normally, 16.15 with Bone Hearts, and 30.9 for Magdalene with Birthright.

Synergies

• Birthright + Magdalene: Allows Magdalene to gain more damage than the other characters can because of her 6 additional heart containers.
• Blood Oath: Activates the damage up effect of Adrenaline for the resulting empty heart containers at the start of each floor.
• Empty Heart: Activates the damage up effect of Adrenaline if an empty heart container is granted at the beginning of each floor.
• Rock Bottom: Allows Isaac to keep the damage up after refilling hearts.

Trivia

• Before v1.06.0190, Adrenaline was named Adderline.
  • Despite having its name changed, Adrenaline's item sprite is named collectibles_493_adderline in the game files.
• Adrenaline is a hormone produced by the body in situations of high stress that increases blood circulation, breathing, and other things in preparation for the natural flight or fight reflex.
• Adrenaline causes characters to have an animation that makes them look like they are breathing rapidly. The more health they're missing, the more exaggerated the animation is.

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