S.E.M.I. - Side Effects May Include… distills cooperative chaos into a relentless, laugh‑out‑loud loop: up to four players become patients scheming their escape from an experimental clinic where randomized drugs, shifting environments, and surprise events rewrite the rules every run. Equal parts physics‑driven brawler, party roguelike, and emergent comedy, the game rewards improvisation, timing, and ruthless teamwork; especially over voice chat; because the pills you swallow grant wild, situational powers while the clinic itself pushes back with traps, changing gravity, and mechanical havoc. Expect frantic moments where brilliant coordinated plays and spectacular failures are one pill away from each other; watch the trailer here:
Core Gameplay
• Co‑op escape runs: Teams of 1–4 race through procedurally assembled clinic wings, clearing rooms, bypassing security systems, and sabotaging infrastructure to reach the exit. Runs are intentionally short, frantic, and built for improvisation, rewarding creative problem‑solving under pressure.
• Tactile combat and emergent physics: Melee brawling, throwable props, and physics‑driven interactions make every skirmish feel chaotic and unscripted; environmental objects can be used as weapons, traps can be improvised, and collisions produce memorable, unpredictable outcomes.
• Dynamic randomized events: Runs are punctuated by dramatic modifiers; shifting gravity wells, moving walls, sudden lockdowns, hallucination effects, and other curveballs; that radically alter tactics and force teams to adapt in real time.
• Voice‑first coordination: Built to be played loud; in‑match voice chat is integral for calling plays, timing pill use, staging rescues, or staging deliberate betrayals, turning communication into a core gameplay mechanic.
• High‑risk, high‑reward pill system: Experimental drugs grant potent, short‑lived abilities with volatile side effects, creating deliberate tradeoffs where momentary power can destabilize the whole team if used without coordination.
• Replayable pocket‑roguelike loops: Modular rooms, randomized hazards, and unlockable cosmetics keep runs fresh, encouraging repeated attempts to refine strategies, chase better loot, and craft the perfect escape.
Experimental Pills: Risk, Reward, and Chaos
Pills are the signature mechanic in S.E.M.I. - compact, high‑variance powerups that radically alter a run’s tempo. Each dose hands you a dramatic, often unstable ability that can flip an encounter from disaster to triumph; or vice versa; depending on timing, team coordination, and a healthy dose of luck.
• Bipolar Force: Temporarily transforms the user into an invulnerable juggernaut with massive melee power and knockback; when the effect expires the player collapses into a stunned, helpless state. Gameplay impact: perfect for clearing a choke or forcing open a door, but leaves the team vulnerable unless teammates clear space or carry the downed patient.
• Laser Astigmatism: Grants powerful, piercing laser attacks with dual, slightly misaligned sights that split shots unpredictably. Gameplay impact: great for long corridors and multi‑target suppression but requires ally cover to avoid friendly fire and stray hits.
• Stendhal Syndrome: Triggers an emotional frenzy that amplifies damage, movement speed, and environmental destruction for a short window. Gameplay impact; ideal for breaking fortified rooms or causing environmental chain reactions, but it also makes the bearer reckless and easier to bait into traps.
• Alice’s Syndrome: Randomly alters the user’s scale, shrinking or growing their model and hitbox. Gameplay impact: tiny players can slip through vents and avoid attacks; giant players can reach high switches and stomp enemies, both states demand teammates adapt positioning and timing.
• Madness State: Induces partial loss of player control; unpredictable dashes, involuntary attacks, or sudden jumps become common, and abilities may fire erratically. Gameplay impact: can create spectacular, chaotic plays but risks turning a coordinated plan into friendly fire; best used as a last‑resort disruptor or when the team is ready to improvise.
How these pills shape play
• Emergent strategy: The volatile effects force teams to think on their feet: use Bipolar Force to break sealed zones, drop a protective barrier while a teammate panics through with Alice’s shrink, or time Stendhal bursts to trigger environmental hazards.
• High risk, high reward: A well‑timed pill can swing an entire run; a poorly timed one can cascade into wipes. That tension is the core loop: short, mortal windows of power that demand coordination.
• Counterplay & mitigation: Teammates can counterbalance liabilities by carrying a stunned patient, baiting enemies away, or using environment traps to safely exploit a rampaging ally. Communication is the most reliable safety net.
Tips & Synergies
• Call your pill: Announce pill use over voice chat so teammates can set up plays or cover downsides.
• Chain effects: Pair Laser Astigmatism with moving platforms or narrow corridors to force enemies into the split beams.
• Use the environment: Stendhal’s destructive streak excels when aimed at explosive containers or hazard arrays.
• Save a countermeasure: Keep one player in reserve to revive or block when Bipolar Force wears off.
• Embrace the chaos: Madness can be a deliberate tactic; bait enemies into killing fields while the mad player runs rampant.
These unpredictable abilities create the game’s most memorable moments: narrow escapes, spectacular failures, and improvised triumphs born from teamwork and quick thinking.
Levels and Encounters
• Procedural clinic wings: Modular rooms are recombined each run to keep routes, environmental puzzles, and choke points feeling fresh; layout variety rewards scouting, quick mapping, and creative sabotage.
• Reactive environmental hazards: Traps, shifting gravity fields, moving walls, conveyor belts, electrified floors, and timed contraptions force teams to coordinate timings and roles rather than brute forcing every doorway.
• Mechanical puzzles and set pieces: Multi‑step room challenges (power reroutes, pressure‑plate sequences, timed elevator shafts) create dramatic moments where one well‑timed pill or clever use of physics turns failure into a spectacular escape.
• Dynamic danger zones: Some areas temporarily alter rules of play; low‑gravity atriums, containment lockdowns, or sensory‑overload galleries; that change movement, sightlines, and combat priorities midrun.
• Distinct enemy archetypes: Staff, guards, orderlies, rogue patients, and automated security each bring unique behaviors: patrols, alarm calls, crowd control, or kamikaze rushes, requiring differing counters and bait strategies.
• Human unpredictability: Because pills can flip allegiances or control, fellow players can become the run’s biggest threat; social reads, quick communication, and fail‑safe revival plans are essential.
• Risk‑reward placement: High‑value pickups and cosmetic unlocks often sit behind the trickiest hazards or puzzles, encouraging teams to weigh immediate survival against long‑term progression.
Progression and Customization
• Cosmetics and room customization: Unlock a wide range of costumes, face paints, accessories, and themed room decorations that let you craft a distinct patient identity and victory staging. Cosmetics are earned through runs, challenges, and seasonal events so each escape can feel visually fresh and personal.
• Meaningful vanity: Many cosmetic pieces interact with pills and animations (e.g., oversized helmets that wobble during Alice’s Syndrome), turning purely visual rewards into small, funny moments that amplify the game’s emergent comedy.
• Post‑run medical reports: Every successful (or spectacularly failed) escape ends with a bite‑size medical report that parodies clinical language and logs player highlights, blame assignments, and memorable quotes; a sharable, replayable scoreboard that rewards daring plays and makes each run storyworthy.
• Meta progression and goals: Track unlocks, collectible sets, and milestone challenges across sessions to give short‑term arcade goals and long‑term collection objectives; completing themed sets can grant exclusive cosmetics or cosmetic‑only perks.
• Seasonal content and events: Regular event cycles introduce limited cosmetics, new room themes, and temporary modifiers that shake up strategies and give players reasons to return.
• Early Access roadmap and community input: Launching in Early Access (Nov 20, 2025) means the team will iterate openly: balance tuning, new pills, enemy types, rooms, and QoL features are planned based on player feedback. Expect public roadmap updates, patch notes, and dev Q&As.
• Quality‑of‑life and accessibility: Ongoing updates will target balance, matchmaking, and accessibility options (controller/keyboard parity, adjustable text, and configurable assist toggles) so the chaotic core stays approachable for more players.
• Monetization stance: Cosmetic and convenience systems are prioritized over pay‑to‑win mechanics; the focus is on fun vanity items and noncompetitive progression so run outcomes remain skill and teamwork driven.
These systems make progression feel rewarding without undermining the core chaotic loop: you keep coming back for the jokes, the stories, and the next hilarious outfit to wear while the clinic collapses around you.
Who Should Play
• Players who love chaotic party games, emergent co‑op moments, and physics‑driven combat.
• Groups that enjoy voice coordination, improvisation, and turning mishaps into memorable victories.
• Fans of roguelike pacing who don’t mind working through a work‑in‑progress Early Access build.
Final Verdict
S.E.M.I. trades predictability for raucous, emergent moments: pills upend every plan, environments demand teamwork, and friends can flip from lifesavers to liability in a heartbeat. It’s a game meant for loud voice chat, quick improvisation, and players who delight in glorious failure as much as hard‑earned victories. Approach it with a crew, expect the unexpected, and savor the absurdity; whether you escape intact, wildly triumphant, or hilariously unhinged, every run tells a story.
Watch and Wishlist
• Add to your wishlist: Wishlist S.E.M.I. on Steam so you get notified at Early Access launch and for sales.
• Mark the date: Early Access begins Nov 20, 2025; add a calendar reminder if you don’t want to miss day-one chaos and launch streams.
• Follow the dev: Keep an eye on Two Horn Unicorn’s official channels for dev updates, patch notes, and roadmap reveals.
• Watch trailers and playtests: Subscribe to the game’s YouTube for trailers, gameplay deep dives, and developer diaries; look for scheduled playtest streams and highlight reels.
• Join the community: Hop into Discord to find teammates, join playtests, report bugs, and discuss pill strategies and meta.
• Social feeds for quick hits: Follow on Twitter and TikTok for teasers, memes, and event announcements.
• Share the hype: Save interesting clips, medical‑report screenshots, and costume reveals to social channels to recruit friends for your first escape run.
Key Takeaways
• Core loop: Four‑player cooperative escapes built around short, frantic runs where improvisation and teamwork determine success.
• Signature mechanic: Experimental pills create high‑variance abilities that flip encounters, encouraging risk‑reward play and emergent moments.
• Chaos meets strategy: Physics‑driven combat and environmental interactions reward creativity but require coordination to avoid catastrophic failures.
• Procedural variety: Modular clinic wings, shifting gravity, traps, and mechanical puzzles keep each run feeling fresh and unpredictable.
• Social play first: Voice chat and in‑match communication are central; coordination, timing, and quick calls turn liabilities into tactics.
• Replay and progression: Cosmetic unlocks, room decorations, and post‑run medical reports give meta goals and shareable highlights.
• Early Access development: Launching as a work‑in‑progress (Nov 20, 2025) with planned community‑driven iteration on balance, features, and QoL.
• Audience fit: Best for groups who enjoy chaotic party roguelikes, physics mayhem, and loud, improvisational co‑op sessions.
• Play expectations: Expect hilarious failures, spectacular saves, and volatile pacing; bring friends, voice chat, and a willingness to embrace glorious unpredictability.
Game Information:
Developer & Publisher: Two Horn Unicorn leads development, publishing, and promotion, keeping creative vision, production, and community outreach tightly integrated to move quickly on player feedback.
Platforms: PC - Steam (reviewed)
Release Plan: Targeted Early Access launch on November 20, 2025, with the game introduced as an evolving work in progress so players can shape features, balance, and content during development.
Score: 9.0 / 10
S.E.M.I. delivers a riotous, brilliantly unpredictable co‑op experience that turns volatile powerups, physics‑first combat, and procedurally shifting clinics into consistently memorable runs. Its combination of emergent comedy, tight risk‑vs‑reward design, and social-driven spectacle makes it a standout party rogue‑lite; especially with friends and voice chat.