Drain Vitality shines because of the skills you’ll need to take on the way to it. Directly beneath it lies Coalesced Blood, a valuable passive that increases your damage while you are Healthy (80% or more HP). This makes Drain Vitality relatively accessible without wasting points on Diablo IV Gold filler nodes.

If your build lacks other reliable sources of Fortify, Drain Vitality becomes a very strong defensive choice. Blood Necromancers, while capable of big healing spikes, often struggle with consistent mitigation-making this passive a safety net.

Why It May Be Less Useful

On the flip side, many endgame setups already include powerful sources of Fortify. Legendary items like Mutilator Plate or other defensive aspects can cover your Fortify needs without requiring point investment in this passive. If you’re already stacking defensive gear, Drain Vitality risks being redundant.

Best Builds for Drain Vitality

Not every Blood build benefits equally from Drain Vitality. Here’s where it shines most:

1. Blood Surge Necromancer

This is the build where Drain Vitality truly shines. Blood Surge rapidly strikes enemies in an area, giving you multiple chances to trigger Lucky Hit effects like Drain Vitality.

Pair this with Cruor’s Embrace, the Unique gloves that supercharge Blood Surge, and you’ll find yourself constantly fortifying while dealing excellent damage. The synergy of Coalesced Blood (damage boost while Healthy) plus frequent Fortify uptime makes this setup both offensive and defensive.

2. Blood Wave Necromancer

For Blood Wave-focused builds, Drain Vitality loses much of its appeal. Blood Wave is a heavy-hitting skill with a cooldown and animation lock, which means fewer opportunities to trigger Lucky Hit passives.

At best, Drain Vitality is a temporary pick for early levels while you’re still gearing up. Once you obtain Mutilator Plate or other Fortify-granting items, you’ll likely respec out of it.

When to Take Drain Vitality

Here’s a quick breakdown of when Drain Vitality fits best into your skill plan:

Early/Mid-Game: Great option if you’re leveling a Blood build and need extra durability before obtaining high-tier gear.

Endgame Without Strong Fortify Gear: Still useful, especially in builds spamming Blood Surge.

Endgame With Fortify Sources (e.g., Mutilator Plate): Largely unnecessary, as other defensive passives or damage boosts may bring better value.

Tips for Maximizing Drain Vitality

Pair with Blood Surge: The more hits you land, the more chances you have to Fortify.

Stack Lucky Hit: Items and aspects that boost Lucky Hit chance improve the consistency of Drain Vitality triggers.

Maintain Healthy Status: Use Coalesced Blood in conjunction, since Fortify and sustain help keep you above 80% HP for its damage boost.

Respec Later: Don’t be afraid to drop the passive once your gear gives you more reliable Fortify.

Final Thoughts

Drain Vitality isn’t a universal must-have, but in the right setup, it can be a cornerstone of a Blood Necromancer’s defenses. If you’re running a Blood Surge build, it’s almost a no-brainer-synergizing perfectly with rapid-hit playstyles. On the other hand, Blood Wave builds or endgame setups with dedicated Fortify gear will find it less valuable.

Ultimately, Drain Vitality is best viewed as a flex pick: highly effective for certain builds and stages of progression, but not always essential. If you’re experimenting with Blood builds this season, it’s worth testing for yourself-you may find that the extra sustain is exactly what your Necromancer needs to survive Sanctuary’s toughest challenges. Having enough D4 Gold can also protect you well.