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Comparing this to Sirenia's debut is what makes fans dislike this album. It's incomparable to "At Sixes and Sevens", or any other album for that matter. "An Elixir for Existence" doesn't grip you instantly like "At Sixes and Sevens", but it requires a couple of more listens to grow on you and for you to appreciate the beauty of it.
The music is not the only thing that takes time to appreciate on this album. The lyrics here (as one can clearly tell even by the track titles) are very melancholic. Drug addiction and suicide are the two most frequent topics featured here. It takes quite some time for one to appreciate them. The lyrical beauty present in each track is incredible. My personal favourite is "Lithium and a Lover", which, obviously, talks about drug dependence..."my river’s bleeding, my fields are burning...my world has stopped turning"
Musically, this album is slightly less heavy than the previous one. However, it has a darker ambience to it. And it's also not as easily accessible (but, obviously, as beautiful). The music is not as heavy as on "At Sixes and Sevens", it's a bit smoother (and a bit catchier). And, like every Sirenia album, the choruses always get stuck in your head.
Vocally, this album isn't that different than its predecessor. The harsh male vocals still dominate, and the female vocals are actually a bit less frequent than the previous album (with the exception of "Save Me From Myself", obviously). However, this is a good thing in my opinion, since I'm not a big fan of Henriette's vocals, since I can't help but compare them to Fabienne's in the previous album. Nonetheless, they still blend in beautifully with Morten's growls.
Choirs seem to be given a bit more importance than they did on the previous album. On tracks like "Voices Within" or "Star-Crossed", choirs make the tracks easier to listen to, and more memorable. The same could be said for violins throughout the album.
One other thing I really liked about this album is that almost every song starts with a brief soft melody (in fact, only "In My Darkest Hours" starts out on a heavy note straight away).
Once again, this album is consistent, and no track disappoints. One track which I think stands out more than the rest, and which I consider to be Sirenia's best song to date, is "Star-Crossed". It's awfully appealing and the climax is very memorable. Some people might prefer "Sirenian Shores" to it, but I prefer this since the melody on "Sirenian Shores" is more or less the same as the one on "Star-Crossed".
This album is just about the last true gothic metal album from Veland, as it all went downstream from here (with "The 13th Floor" being a slight improvement). Highly recommended.