Damocles 
Effects
- Upon use, summons a sword that hangs directly above Isaac. As long as the sword hangs above Isaac, all item pedestals and items spawned from Machines and Beggars are doubled, spawning an additional free item next to them.
- The extra item spawned will be pulled from the current room's item pool.
- (Mega Chest) Mega Chests will also spawn an extra item if they contained items.
- After Isaac gets hit once with the item activated, at any time with only a brief warning, the sword may fall, instantly killing Isaac regardless of his health. The sword has a 1/10000 chance every 4 frames to fall, so on average, 50% of all Damocles runs will not drop the sword until after at least 15 minutes and 24 seconds have passed.
Notes
- The chance for the sword to fall does not increase beyond the first hit taken.
- In scenarios that have multiple items to choose from (such as rare double (Treasure Room) Treasure Room layouts and (Boss Rush) Boss Rush), an additional set of items for Isaac to choose from spawns. Only one item from each set can be taken.
- Having multiple Damocles active at once does not spawn additional items.
- The only way Isaac can survive the falling sword is if he's invincible at the time it falls or, by technicality, with a respawn item. After the sword falls, extra items will no longer spawn.
- Losing a life before the sword falls does not remove the sword or its threat.
Synergies
Book of Virtues: Spawns a wisp on the middle ring, looking like a sword. The wisp's tears look like 
Spirit Sword's beams, but there are no other effects. Likely not fully implemented.
Interactions
Blood Oath: Getting stabbed by Blood Oath does not trigger the chance of falling.- (Butter!) Butter!: Using active item will drop it and spawns an extra item pedestal on the ground; Getting hit may cause Isaac to drop the sword, removing the effect and chance of falling.
Clicker: The sword cannot be removed from Isaac's inventory.
D4 / 
D100 / (Tainted Eden) Tainted Eden: The sword does not get rerolled.
Holy Mantle: Does not protect Isaac from death when the sword falls.
Isaac's Heart: Taking damage still allows it to fall, and the sword will still kill Isaac if it falls.- (Jacob and Esau) Jacob and Esau: The sword will only gain the chance to fall if the brother who used it takes damage.
Kamikaze!: Isaac blowing himself up does trigger the chance of falling.
Metronome: Can invoke the effect of Damocles, which will apply permanently.- (Panic Button) Panic Button: Does not activate when the sword falls on Isaac.
- (Tainted Eden) Tainted Eden: Damocles does not reroll when damage is taken.
- (Tainted Forgotten) Tainted Forgotten: The sword will hang over Tainted Forgotten's body but will still kill the character despite being invincible.
- (Tainted Isaac) Tainted Isaac: Damocles does not count toward his passive item count, and cannot be removed.
- (Tainted Lazarus) Tainted Lazarus: The character that used Damocles must be active for double items to spawn.
- In the case of (Boss Room) Boss Room, the character that did not use Damocles must fight the boss for it to drop double items.
- If the player has
Birthright and the inactive form has Damocles, the sword can fall on them and kill the player, bypassing the inactive form's immunity to damage.
- (XVII - The Stars?) XVII - The Stars?: The sword will not be removed from Isaac's inventory.
Synergies
Blanket / Holy Mantle / (Holy Card) Holy Card / (Wooden Cross) Wooden Cross: Damage blocked by the shield doesn't count as damage taken. It will not, however, protect Isaac from the falling sword.
Book of Shadows / 
Empty Vessel / (Rune of Algiz) Rune of Algiz / other items that give shield: Nullifies the instant kill of Damocles if the shield is active when the sword falls.
Cone Head / 
Host Hat / 
Infamy / 
Metal Plate: Blocked damage does not count as damage and can delay the triggering of Damocles.
Crooked Penny / 
Diplopia: An extra item is spawned per each item cloned.
Dark Arts: When in the shadow state, Isaac can survive the instant kill of Damocles, though this requires precise timing and can be impossible if Dark Art's charge is empty as the sword is falling.
Gnawed Leaf: If in the form of the statue, Isaac will be immune to the falling sword.
Tooth and Nail's statue form can also save Isaac, but the statue transformation time lining up with the sword falling is unlikely.
- (The Lost) The Lost / (Tainted Lost) Tainted Lost: Any damage the Lost would take is likely to kill him instantly, meaning that the item's downside is greatly mitigated. Dying and respawning, however, will still trigger the chance of falling,
Magic Skin: Spawns 2 items on every use instead of 1.
My Little Unicorn / 
Unicorn Stump / other items that give invulnerability: If active, will negate the sword's fall killing Isaac.
Mega Mush: When activated, protected from falling damocles.- (Tainted Lazarus) Tainted Lazarus: If Tainted Lazarus takes damage, swapping to (Dead Tainted Lazarus) Dead Tainted Lazarus will cause the game to 'forget' that he took damage when he swaps back, and vice versa, making this item much safer than usual to use.
