S.E.M.I.: Side Effects May Include...

About

S.E.M.I.: Side Effects May Include... is a single player and multiplayer arcade hack and slash game with a comedy theme. It was developed by Two Horn Unicorn and was released on January 23, 2026. It received positive reviews from players.

S.E.M.I. is a cooperative online game about escaping from a special clinic. Here you and up to 3 of your feeble-minded loyal friends in the role of patients fight with the staff and other patients and find yourself in unexpected situations. Teamwork is essential, as randomized events and experimental drugs will lead your party into unpredictable mayhem. Pop pills with your friends as you cooperate…

S.E.M.I.: Side Effects May Include... screenshot

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83%

Audience ScoreBased on 29 reviews

humor8 positive mentions

stability2 negative mentions

Fun and chaotic multiplayer experience, especially enjoyable with friends or partners.
Unique and original concept blending surreal humor, narrative, and puzzle elements with emotional depth.
Appealing art style, character customization, and entertaining pill side effects creating unpredictable gameplay.

Performance issues, bugs, and control problems affect gameplay, particularly in platforming sections.
Some puzzles and cooperative mechanics feel poorly executed or too difficult for solo play.
Repetitive elements, overstimulation, and occasional pacing issues may reduce enjoyment for some players.

gameplay
9 mentions Positive Neutral Negative
33%
34%
33%
The gameplay combines visual novel storytelling with light adventure and environmental puzzles, focusing on narrative and character-driven experiences rather than mechanical complexity. It uses the unpredictability of pharmaceutical side effects as a unique storytelling and gameplay element, offering fresh, varied moments each chapter. While accessible and not action-heavy, it appeals to players who appreciate inventive, risk-taking indie games with branching dialogue and meaningful themes.
- “Developed and published by Two Horn Unicorn, the game leans into the absurdity and unpredictability of pharmaceutical side effects as a storytelling mechanism—using strange, sometimes comedic, sometimes unsettling physical and psychological reactions to drive both plot developments and gameplay mechanics.”
- “Moment-to-moment gameplay mixes visual novel storytelling with lightweight adventure design and environmental puzzles.”
- “While mechanically approachable and never overly complex, the variety keeps pacing lively and ensures that each chapter introduces something fresh rather than repeating a single formula.”
- “The drug element doesn't really make any sense and isn't even really a part of the gameplay... like, sure, you could maybe fly with one drug but it's random and rare.”
- “Some players may wish for deeper mechanical challenge or more complex puzzle systems, as the gameplay remains accessible and story-focused throughout.”
- “It may not cater to those seeking mechanical complexity or action-heavy gameplay, but for players who enjoy character-driven storytelling, branching dialogue, inventive presentation, and indie games unafraid to take risks, it delivers a memorable and meaningful experience.”
humor
8 mentions Positive Neutral Negative
100%
The humor in "side effects may include" is widely praised for its blend of surreal, absurd moments and emotional depth, often serving as a coping mechanism within the narrative. Players find the comedic interactions—especially the goofy downed states and cartoonish sound effects—both hilarious and a key part of the game's charm. Overall, the humor enhances the game's imaginative and heartfelt storytelling while delivering plenty of laughs.
- “Has been a hilarious add for our group of friends to play together.”
- “The way you are downed is so stupid and funny we spent too much time just hurting each other.”
- “– side effects may include is a narrative-driven indie adventure that immediately sets itself apart through its blend of surreal humor, grounded emotion, and light puzzle-based progression.”
story
8 mentions Positive Neutral Negative
38%
49%
13%
The story cleverly uses the absurd and unpredictable effects of pharmaceutical side effects to drive a unique narrative blending humor and emotional depth. Its visual novel style, combined with light adventure and puzzles, fosters immersive character-driven storytelling with meaningful choices impacting relationships and outcomes. While accessible and focused on narrative over mechanical complexity, it offers a memorable, risk-taking indie experience for players who appreciate inventive, emotionally resonant stories.
- “Developed and published by Two Horn Unicorn, it leans into the absurdity and unpredictability of pharmaceutical side effects as a storytelling mechanism—using strange, sometimes comedic, sometimes unsettling physical and psychological reactions to drive both plot developments and gameplay mechanics.”
- “Humor becomes a coping mechanism, not a dismissal, giving the story more emotional depth than its comedic premise initially suggests.”
- “It may not cater to those seeking mechanical complexity or action-heavy gameplay, but for players who enjoy character-driven storytelling, branching dialogue, inventive presentation, and indie games unafraid to take risks, it delivers a memorable and meaningful experience.”
- “Some players may wish for deeper mechanical challenge or more complex puzzle systems, as the gameplay remains accessible and story-focused throughout.”
emotional
6 mentions Positive Neutral Negative
100%
The game delivers emotional depth by blending humor with sincere themes of burnout, anxiety, and self-improvement, supported by a responsive world and evocative soundtrack. Its use of humor as a coping mechanism adds heartfelt nuance, while player choices significantly impact the emotional resonance and variety of endings.
- “Rather than treating the concept as pure satire, the writing weaves in themes of modern burnout, medical anxiety, identity, and the desire for self-improvement, grounding its comedic premise with emotional sincerity.”
- “It feels like a world constantly shifting in response to the protagonist, and that responsiveness becomes one of the game’s strongest emotional hooks.”
- “Humor becomes a coping mechanism, not a dismissal, giving the story more emotional depth than its comedic premise initially suggests.”
graphics
2 mentions Positive Neutral Negative
100%
The graphics feature a cool art style and characters, enhanced by unlockable outfits and decorations that add depth. Despite some performance issues and bugs in early access, the visual chaos contributes positively to the overall experience.
- “The art style and characters are pretty cool, and unlocking new outfits and decorations adds a nice extra layer to the experience.”
- “I started playing in early access, and even then there were some performance issues, bugs, and overly difficult platforming, but the fun of the graphical style and the chaos that is happening made up for it.”
stability
2 mentions Positive Neutral Negative
100%
The game's stability is currently poor, with increased bugs and frequent micro-freezes that disrupt gameplay. Additionally, platforming issues and limited cooperative features further detract from the experience, making it buggy and unbalanced.
- “With the release, the bugs and micro-freezes only increased, the platforming became more annoying, and the cooperation is just for show (the most you can do is revive a fallen comrade, who at this time is stuck upside down and can't even watch other players).”
- “Bit too buggy and unbalanced to enjoy right now.”
optimization
1 mentions Positive Neutral Negative
100%
Optimization has shown improvement since early access, though some performance issues and bugs remain. Despite these challenges, the game's engaging graphical style and chaotic gameplay help offset technical shortcomings.
character development
1 mentions Positive Neutral Negative
100%
The character development is highlighted through expressive designs, dynamic animations, and exaggerated reactions that effectively convey the protagonist’s emotional and physical states, enhanced by shifting color palettes. This approach adds depth and visual storytelling to the characters.
music
1 mentions Positive Neutral Negative
100%
The music features whimsical melodies, ambient electronic pulses, and soft emotional themes that effectively enhance the game's tone and smoothly adapt to symptom-triggered events.
- “The soundtrack further supports the tone with whimsical melodies, ambient electronic pulses, and soft emotional themes that seamlessly transition during symptom-triggered events.”

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Frequently Asked Questions

S.E.M.I.: Side Effects May Include... is a arcade hack and slash game with comedy theme.

S.E.M.I.: Side Effects May Include... is available on PC and Windows.

S.E.M.I.: Side Effects May Include... was released on January 23, 2026.

S.E.M.I.: Side Effects May Include... was developed by Two Horn Unicorn.

S.E.M.I.: Side Effects May Include... has received positive reviews from players. Most players liked S.E.M.I.: Side Effects May Include... for its humor but disliked it for its gameplay.

S.E.M.I.: Side Effects May Include... is a single player game with multiplayer and local co-op support.

Similar games include Henry Halfhead, Space Otter Charlie, Embr, GwenBlade, Revenge of the Savage Planet and others.

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