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

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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 mostly positive reviews from players.

S.E.M.I.: Side Effects May Include... is a chaotic cooperative game where up to four players escape a special clinic by overcoming puzzles, traps, and intense brawls. Players control quirky patients who use unpredictable special pill-induced abilities to fight staff, sabotage rooms, and solve challenges. Teamwork, quick thinking, and voice communication are key to surviving each hazardous scenario.

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79%

Audience ScoreBased on 24 reviews

humor6 positive mentions

story3 negative mentions

The game is a lot of fun, especially when played with friends, offering chaotic and humorous moments.
Customization options for characters add a fun element to the gameplay, enhancing the overall experience.
The narrative-driven adventure combines surreal humor with relatable themes, making it an engaging and memorable experience.

The game suffers from performance issues, bugs, and overly difficult platforming that can detract from enjoyment.
Some puzzles are challenging to complete solo, suggesting it should be marketed as a multiplayer experience.
Control customization options are limited, which can be frustrating for players using different platforms.

gameplay
9 mentions Positive Neutral Negative
33%
34%
33%
The gameplay combines visual novel storytelling with lightweight adventure elements and environmental puzzles, offering a unique blend of absurdity and unpredictability influenced by pharmaceutical side effects. While it remains accessible and story-focused, some players may desire more mechanical depth or complexity. Overall, it caters well to those who appreciate character-driven narratives and inventive design, providing a memorable experience.
- “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.”
- “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.”
story
8 mentions Positive Neutral Negative
13%
49%
38%
The story is characterized by its absurd and unpredictable exploration of pharmaceutical side effects, blending comedic and unsettling elements to drive both plot and gameplay. It features a visual novel style with branching dialogue and character relationships that influence the narrative's tone and outcomes, enhancing immersion without heavy exposition. While some players may desire more mechanical complexity, the game offers a memorable experience for those who appreciate character-driven storytelling and inventive presentation.
- “These choices influence relationships with supporting characters, altering tone, trust, and eventual story outcomes.”
- “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.”
- “Some players may wish for deeper mechanical challenge or more complex puzzle systems, as the gameplay remains accessible and story-focused throughout.”
- “Humor becomes a coping mechanism, not a dismissal, giving the story more emotional depth than its comedic premise initially suggests.”
humor
6 mentions Positive Neutral Negative
100%
The humor in "side effects may include" is characterized by its surreal and imaginative approach, blending comedic elements with grounded emotional themes. Players appreciate the game's ability to use humor as a coping mechanism, enhancing the narrative's depth while providing entertaining and chaotic puzzle challenges. Overall, the game is recognized for its heartfelt and often hilarious moments, making it a standout in the indie adventure genre.
- “– 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.”
- “Humor becomes a coping mechanism, not a dismissal, giving the story more emotional depth than its comedic premise initially suggests.”
- “– Side Effects May Include succeeds as an imaginative, heartfelt, and often hilarious narrative adventure that balances surreal creativity with grounded emotional truth.”
emotional
6 mentions Positive Neutral Negative
100%
The game effectively blends humor with deep emotional themes such as burnout, identity, and self-improvement, creating a narrative that resonates on multiple levels. Its whimsical soundtrack enhances the emotional experience, while player choices lead to varied endings that can impact emotional satisfaction. Overall, it presents a heartfelt and imaginative adventure that balances comedy with genuine emotional depth.
- “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.”
optimization
3 mentions Positive Neutral Negative
100%
The game's optimization has faced criticism due to performance issues and bugs, particularly noted during early access. However, many players feel that the engaging graphical style and chaotic gameplay compensate for these shortcomings.
- “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 happening made up for it.”
- “The game suffers from severe optimization issues, leading to frequent frame drops and crashes that ruin the experience.”
- “Despite the interesting gameplay mechanics, the lack of proper optimization makes it nearly unplayable on lower-end systems.”
character development
3 mentions Positive Neutral Negative
100%
Character development is enhanced through expressive designs and playful animations that reflect the protagonist's emotional and physical states, utilizing exaggerated poses and contrasting color palettes to convey depth and transformation.
- “The art direction embraces expressive character designs, playful animation, exaggerated reaction poses, and contrasting palettes that shift with the protagonist’s physical condition.”
- “The character development is incredibly deep, allowing players to form genuine connections with each character as their backstories unfold.”
- “I love how the choices I make impact the characters' growth and relationships, making every decision feel meaningful.”
stability
2 mentions Positive Neutral Negative
100%
The game's stability has been criticized for an increase in bugs and micro-freezes since release, leading to frustrating platforming experiences and limited cooperative gameplay. Overall, players find it too buggy and unbalanced to enjoy at this time.
- “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).”
- “A bit too buggy and unbalanced to enjoy right now.”
graphics
1 mentions Positive Neutral Negative
100%
The game's graphics are praised for their engaging style and chaotic visuals, which enhance the overall experience despite some performance issues and bugs noted by players.
- “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 happening made up for it.”
music
1 mentions Positive Neutral Negative
100%
The music features whimsical melodies and ambient electronic elements that enhance the game's tone, with soft emotional themes that transition smoothly during key 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 mostly positive reviews from players. Most players liked this game 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 Kraken City, Anxiety Puppy, Star Story: The Horizon Escape, Babushka's Glitch Dungeon, Haimrik and others.

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