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With Patch 4.10 Riot nerfed Lifesteal overall. There was also slight nerf (a bit more negative than a rebalance for ADCs) to Dorans Blade.

With these Changes I'm not entirely sure of how I should start as an adc right now. Is Dorans Blade still the first choice or are there other options that are just as good or even better?

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    Actually, the Dblade changes make other builds more viable. You no longer have to go BT->other items anymore. You can start double dorans into Iedge, making caitlyn ashe and tristana a lot more viable picks now – eyeofthehawks Jun 25 '14 at 19:30
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Mostly answering your answer with my own

Doran's blade/potion is still probably the best start. It gives you some early natural sustain and HP. Both are extremely important. Currently, people will build 2-3 Doran's blades and skip right over the vamp scepter in favor of something else for more damage like IE. The % LS is enough so that the vamp scepter is no longer necessary.

Longsword + 3 pots isn't really as viable because when you upgrade it to a vamp scepter, the Opponent will have 2 doran's. You don't get a ton of lifesteal or damage out of vamp scepter anymore. Doran's also gives 140 HP on top of that which would be pretty significant for an early fight. You can't afford to lose these early fights because then you can get zoned even with your vamp and miss out on CS.

Boots + 4, I have never seen anyone start boots since season 2. Starting boots just puts you so far behind ATM. (there MIGHT be 1-2 niche cases where it could be useful but you would have to convince me of that especially with the nerfs t1 boots got awhile back) You will simply lose every trade here. Getting the early boots isn't going to help you win trades and it's only useful to help to rush to berserker's greaves which probably isn't still enough of an upgrade.

TL;DR; Doran's blade is probably the best start ATM since you can stack the lifesteal and vamp scepter has been nerfed. This allows you to stack dorans and start saving for another high damage item without burning that 800g on a vamp scepter that gives very little in stats.

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With the nerf of Dorans blade (-10HP, -1 AD, 3 HP On-Hit, + 3% Lifesteal), it's no longer a must-buy ADC Item. Basically there are 3 starting options right now:

  • Dorans Blade + 1 Pot
  • Longsword + 3 Pots
  • Boots + 4 Pots

Dorans Blade
There are 2 Situations where a Dorans is better than other starting options. The first would be if you are champion that has On-Hit Proc Spells which deal 100 Damage +. The other situation is if you are playing against a Burst comp bot. The 70 HP give you a bit more Survivability, The 7 AD makes Lasthitting easier and the Lifesteal will be okay if you are able to deal 100 damage or more.
Pro: More Survivability, Easier to Lasthit
Con: Not really that much sustain, You can't build the item into anything

Longsword
This would be the best start for most champions. It gives a lot of sustain (even more with LS runes) and it's really easy to lasthit creeps with this start. Also your spells and attacks deal more damage so trading does work quite well. You shouldn't take it agains burst comps though since you have 70 HP less. The best thing about this item is that it's buildable into core items.
Pro: Highest damage, High Sustain, Can be built into Vamp Scepter
Con: Squishy

Boots
Boots are also an option that work better now with the Dorans nerfs. They were viable before but Dorans was just a better choice. The best part of boots is that they allow you to dodge things, so you can actually pick them against skillshot (burst) champions like Thresh and Leona. With other burst champions you have to be careful (Alistar, Sona) since those are non-skillshot based bursters.
Pro: High mobility, High sustain, Can be built into full boots
Con: Squishy, Harder to lasthit

TL;DR

  • Buy dorans Blade if you are against a Burst comp or if you have attacks/spells that deal more than 100 damage.
  • Buy Longsword if you want to play rather passively and if you are against sustain-lanes.
  • Buy Boots if you want as much sustain as possible and if you have to dodge stuff.
  • Just to note that you can now stack Doran's unlike before. – Jonathan Drapeau Jun 20 '14 at 11:51
  • @JonathanDrapeau You could stack dorans before. It was a Passive not an Unique Passive. Now it's just better than before still not good tho. – Jutschge Jun 20 '14 at 11:54
  • you're right, forgot it wasn't unique. – Jonathan Drapeau Jun 20 '14 at 12:14
  • Dblade also scales into late game better with the return of the % lifesteal passive. Although you need to consider uninstalling if you happen to still have it 30-40 min into the game. – slow_excellence Jun 25 '14 at 19:27
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    I disagree with most of your post. Longsword start is almost never good, and starting boots is awful as it gives you zero combat stats in lane. – eyeofthehawks Jun 26 '14 at 14:16
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You still start Doran + pot, you buy another Doran, then you're set for the lifesteal up until you complete your two next items, Berzerker Boots and Infinity Edge. That's the common best start nowadays.

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Dorans Blade Start is still your best bet on every ADC. Its fairly arguable that it is actually better the old Dorans Blade. Now let me explain this:

Old Dorans Blade
- 80 hp
- 5 life/hit melee, 3 life/hit ranged
- 8 attack damage

New Dorans Blade
- 70 hp
- 3% lifesteal
- 7 attack damage

So how is this better?

Technically... until you are doing 100 attack damage per hit it is explicitly worse. You get less life per hit (since Lifesteal is applied on the damage done after armor mitigation) than the old Dorans Blade.

The key to the new Dorans blade is it's potential for mid and mid-late game. Since it now offers lifesteal, it scales WITH you.

There are some other points worth mentioning. Other early game lifesteal items got nerfed in the last patch too. Both Bilgewater Cutlass and Vamp Scepter only have 8% lifesteal now.

Vamp Scepter:
- 800 gold
- 10 attack damage
- 8% lifesteal

2 Dorans Blades:
- 950 gold
- 14 attack damage
- 140 hp
- 6% lifesteal

What does this mean?
Essentially, it opens up a lot more build paths for AD Carries.

Prior to this patch, ADCs had two options:
- Build Bloodthirster/BotRK first
or
- Lose lane

With the changes, ADCs can go double dorans into Infinity Edge, or any other non-lifesteal based late game item. Which increases the power of pretty much all auto attack reliant, non-ability based ad carries (Tristana, Ashe).

I guess I went on a bit of a tangent, but this is the reasons why you start Dorans Blade, because it is better.

  • And 2 Doran's blades gives you also 140 hp! – Fabián Jun 26 '14 at 14:36
  • @Fabián Oops forgot to write that! – eyeofthehawks Jun 26 '14 at 14:37

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