If the PhD has been obtained, unknown pill types have a chance to be revealed (1/150 chance every frame). Pills are on the Collection Grid (8,5) and are unlocked by finding any random pill. Speed Up increases speed by 30% while Speed Down decreases speed by 24%). Negative pill effects, except for Health Down, have an 80% effect of their positive counterparts (e.g.
Only one pill can be held at a time, and picking up another pill will drop whatever is held in the "Q" slot. Both the PHD and Lucky Foot items will almost always replace all negative stat pill effects with their positive counterparts (neutral effects such as Telepills and Bad Gas are not affected), however, it is still possible to be affected by negative stat pills (such as health down or bad trip). Pill effects can vary from one-off effects to permanent changes. Note, however, that if a pill has been used with a certain effect, the same effect may recur with a different pill as well (some examples below). The same goes for additional duplicates that are found. However, if a pill is used and another pill is picked up of identical colors in that playthrough, it will have the same effect as before and its name will be shown, replacing "?". Note, the pills do not work like Tarot cards which effects can be learned before use, the color of a pill does not foretell its effect in any way.
They come in many colors and the effects change every time you play. Pills are random items that are dropped by enemies, found in chests, or spawned in rooms.
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