Obtainable after defeating Signus.
Let's start with Laudanum. Of the debuffs it affects, the only ones the average player is most likely to run into are Armor Crunch, Bleeding, Broken Armor, Chilled, Cursed, Darkness, Slow,
Though really, I phrased that wrong: almost all of those are inflicted by 4 hazards in the dungeon (and one of them is genuinely dungeon spikes) and a small handful of abyss enemies, plus Ravager and Ice Queen. Sure, there are other sources outside of the Dungeon and Abyss, but in almost every scenario you can simply obliterate the threat before it can touch you. Furthermore, who cares if your 130-something defense gets reduced by 10 for 15 seconds? Is that worth an entire accessory slot? That is a beyond sorry state for this part of the accessory to be in.
Next, Heart of Darkness. I don't have much to say because what is there to say about this item
Finally, the part of the accessory that matters: Stress Pills. Obviously they give you 5 defense and 1.05x acceleration and max movement speed, and I mean that's rather negligible but they are nice, I won't deny that. But the main function of the accessory...
Adrenaline traditionally takes 30 seconds to fully charge and lasts for 5 seconds. Being generous and assuming you have all upgrades allows you to have up to 3.1x your normal dps. For example, let's say you have an average dps of 100. Adrenaline gives you five seconds of 310 dps, for a total of 1050 extra damage. Comparing this to our original dps we can see that without adrenaline we would have done 3500 damage, but with it we did 4550! That's an entire 30% multiplicative damage boost with a single mechanic.
Now, let's check with Stress Pills. They allow you to charge in only 25 seconds, so that means we have 1050 extra damage compared to 3000... which is a damage increase of... 35... percent... in other words it increases your damage by ~1.0385x. Yikes.