The indie scene has a fascination with high-stakes, gamble-with-your-life mechanics (thanks, Buckshot Roulette), and SIDE EFFECTS is the latest twisted entry in this dark subgenre. Published by Free Lives (Broforce, Genital Jousting), this game seats up to four players at a grimy table for a “medical trial” where the only way out is to be the last one breathing.
It’s simple, tense, and delightfully cruel. You take pills. Some help you, some hurt you, and some kill you instantly. The goal is to manage your “resistance” while using items to screw over your opponents. It’s a game of bluffing, luck, and watching your friends panic while you sit there like Homelander, convinced you can’t die.
“A twisted trial of pill roulette for up to 4 players (solo or online). Pick your poison. Use experimental items to shift the odds. And remember: only one of you can survive.”
It’s the perfect party game for people who think Mario Party isn’t stressful enough.
Pick Your Poison
The core loop is deceptively simple. You and up to three other test subjects are presented with a selection of pills. You have to take them. Every pill impacts your resistance, and if that resistance hits zero, you die. The tension comes from the unknown—you don’t always know what you’re swallowing.
This is where the items come in. Between rounds, you draft experimental treatments like vaccines, mouth clamps, and boosters. These allow you to shift the odds, peek at pill effects, or force opponents to take risky doses. It creates “absolutely disgusting combos” that can turn a sure loss into a hilarious victory.
Multiplayer Mayhem
While the single-player mode is fine for learning the ropes, SIDE EFFECTS thrives in multiplayer. Watching someone pick the wrong pill and “instantly drop to zero resistance” is, as one player put it, “beautiful.” The psychological warfare is real. Players try to bluff confidence, but there’s always that one guy who eats pills like candy and somehow wins.
However, the multiplayer experience is currently a bit rough around the edges. Host migration is non-existent, meaning if the host rage-quits after dying (which happens often), the lobby dies with them. There are also reports of bugs, like pills disappearing or AI characters staring lovingly into your eyes while the game soft-locks. It feels like a game that needed just a little more time in the oven.
A Promising Prescription
Despite the bugs, SIDE EFFECTS is “very entertaining and hard to put down.” It’s inexpensive (around $5), accessible (works well on Linux and for players with disabilities), and features a creepy art style that creates the perfect dark atmosphere.
It’s a game of “bad decisions, good times.” If you can tolerate some early-access-style jank and the occasional rage-quitting host, this is a fantastic little gem to play with friends. Just remember: you’re not lucky, they’re just bad.
Pros & Cons
| Pros | Cons |
| ✅ Addictive Gameplay Loop: Simple, tense, and endlessly replayable. | ❌ Multiplayer Issues: Host rage-quits kill lobbies; needs host migration. |
| ✅ Great Party Game: Hilarious with friends, full of bluffing and betrayal. | ❌ Bugs & Glitches: Soft-locks, disappearing items, and UI errors are present. |
| ✅ Creepy Atmosphere: The dark, medical trial aesthetic works perfectly. | ❌ No Local Co-op: A missed opportunity for couch play. |
| ✅ Strategic Items: “Disgusting combos” allow for deep tactical plays. | ❌ Unfinished Feel: Some mechanics feel slightly undercooked. |
| ✅ Very Accessible: Easy to pick up, playable with limited mobility. |
SIDE EFFECTS: This is a fantastic, twisted little strategy game that punches well above its $5 price tag. It captures the thrill of Russian Roulette but adds layers of strategy and item management that keep it fresh. While it suffers from some technical gremlins and multiplayer stability issues, the core experience is so fun that you'll likely forgive it. Grab three friends, hop in a discord call, and see who survives the trial. It’s a blast. – Flare