Reference

Start each run Cursed.

All enemies have deadlier attacks.

Fight two bosses at the end of Act 3.

Less Rest Sites.

Play without any Ascension modifiers.

Enemies and Treasure Chests drop 25% less Gold.

Rare and Upgraded cards appear less often.

Elites spawn more often.

Start each run with 1 less potion slot.

All enemies are harder to kill.

Ancients only heal 80% of your missing HP.

Start with 5 colorless cards.

Elite enemies swarm the Spire and drop better rewards.

Card rewards now contain only 2 cards.

At the start of each Act, add a random Curse to your deck.

Unknown rooms can now contain Elites, but are also more likely to contain Treasure rooms.

Choose 10 card rewards to replace your starting deck.

You may ignore paths when choosing the next room to travel to.

Whenever you add a card to your deck, add 2 additional copies. You can no longer remove cards from your deck at the Merchant.

Start with a random deck of 30 cards.

Enemies drop 200% more gold, but you can no longer Smith at Rest Sites.

You start each combat with 3 Strength. All enemies start combat with 3 Strength.

Resting at Rest Sites heals all of your HP, but costs 5 Max HP.

Choose 10 out of 30 cards to replace your starting deck.

Start with 5 copies of a single card.

Whenever you enter a new room, lose 1 Max HP. Start each combat with 5 Plating.

Normal enemies drop relics instead of cards.