Side Effects | PC Review
Side Effects is a high stakes game of death roulette similar in concept to Buckshot Roulette. It’s you vs others in a deadly game of pharmaceutical horror. You are taking part in a hellish medical trial that make you question the sanity of continuing forward.
Deadly Turn-Based Horror
The core loop involves taking drugs that are randomly dispensed onto the table in front of you. You are told how many pills are toxic, how many are placebos, but no idea how to identify which ones they are. This is the core mechanic of the game. Do you risk taking an unknown pill and hope the gamble pays off? Do you pressure your opponent into taking one instead hoping that they are unlucky? The risk/reward aspect of the game really does draw you in.
Creepy Atmosphere
The game really draws on the creep aesthetic. Everything feels filled with dread and gloom. People appear distorted and grotesque, including yourself. As you play bruises and other harm begin to take their toll. Every dosage brings you closer to death. The environment feels like a doctor’s office from the other side. Not so much a hospital as some kind of sick experiment in a back alley.
Fun Mechanics
There is a sophisticated tool system that really shines here. The tools give you different advantages depending on their use and how you use them. Use a hammer to smash a pill and take it out of play. Take out a pair of pliers and pull an opponent’s tooth to force them to take damage and swing ever closer to death. Make a copy of a vital tool to give you an advantage later. Successfully managing your tools is it’s own subgame within the main game. It takes something that would be completely random and gives you some tactical ability. You need to think several moves ahead to be successful instead of pure luck.
Final Verdict
Side Effects is a successful and disturbing evolution of the game type. It takes the randomness of roulette and adds tactical strategy. The creep factor of the graphics really fill you with a sense of dread and foreboding. Whether you want to play solo or with others this is a must play for anyone who appreciates this genre.
To hear me talk more about Side Effects, be sure to listen to the December 17th, 2025 episode of The Gaming Outsider Podcast around the 57:12 time stamp.
This review is based on a Steam copy of Side Effects provided by Future Friends Games for coverage purposes. As of this writing, it is exclusive to that platform.
Side Effects
$4.99
Pros
- Tactical Item System
- Oppressive Atmosphere
Cons
- High Dependence on Luck
- Intense Visuals
- Learning Curve
