Item: Ouija Board
Head of the Keeper
Isaac's tears become coins and now have a chance to drop pennies on the floor upon successfully hitting an enemy.
Charm of the Vampire
Heals the character for half of a red heart for every 13 monsters killed.
Spawns a familiar that will follow Isaac's movements on a 2.5 second delay. Tears that pass through the baby will be doubled and increase in speed.
After Isaac takes damage, this fly will deal continuous touch damage to whatever enemy caused the damage until it is dead. The fly will then systematically attack 1 enemy at a time until the room is cleared.
1-3 Blue flies randomly spawn every time Isaac gets hit.
Isaac is followed by a small bag that drops a Bomb, 1+1 Free, or a Troll Bomb every 3 rooms.
Whenever Isaac takes damage, a black ring briefly appears around Isaac, dealing damage to all nearby enemies.
Has a chance of spawning a soul heart or black heart when taking damage. Enemies have a chance to drop a Half Red Heart after being killed.
Tears are replaced with piercing white blasts of light.
Curse of the Tower
Causes Isaac to spawn 6 troll bombs on the floor every time he gets hit, similar to the Anarchist Cookbook mechanic.
Tears leave a small, short lasting pool of creep on impact or when their range is depleted.
There will be 2 items available to choose from after defeating a boss. Choosing 1 item causes the other to disappear.
Has a chance to fire tears that inflict bleeding on enemies, causing them to slowly take damage over time.
Grants a familiar that transforms into another random familiar every 10 seconds.
Grants Isaac 1 Black Heart and 3 bombs. Can also give troll bombs.
Lord of the Pit
Grants flight and increases speed.
Increases damage by a flat 0.1 and grants a soul heart. Enemies can randomly become briefly charmed or feared. Taking damage has a chance to spawn a rainbow poop.