Side Effects: Russian roulette meets popping pills

In life, there are many hard pills to swallow, but none harder than the ones you must (or are forced to) swallow in Side Effects.  

This fun pill roulette game, published by Free Lives in November 2025, soon gained a lot of popularity for its addictive horror-like nature and multiplayer capabilities. 

The game is set in some sort of medical testing facility, where you and other players, or, in my case, an AI NPC, are pitted against each other to test the side effects of pills. 

Of course, in true Russian roulette fashion, these pills will eventually kill one of you. 

The aesthetic of the game is perfectly unsettling and creepy

To aid your chances of survival, the game provides random items that you can choose to bring into each round before it starts. These includes things such as a pill tester, hammer, eye extractor that force-feeds your opponent your eyeball to their diminish stats, or a force-feeding harness, to name a few. 

The aesthetic of the game is perfectly unsettling and creepy. The way in which some of the items are used successfully adds to the horror elements and forces me to instinctively clear my throat as my character chokes on an eyeball.  

I also enjoy how you can see the side effects of the pills on your opponent, as their facial features change and their hands develop all sorts of rashes and boils. Of course, your hands show the same, so you can only assume how horrible you must look yourself. 

The occasional dipped head tilt of your opponent also adds to how uncomfortable you feel, as you usually can’t see their face during your turn in single player unless they perform this action. 

That being said, the game does have its downsides.  

Occasionally, albeit rarely, I run into a glitch or two that forces me to close the game even if I am far into the round. This includes things like no items for me to choose in between rounds (or items have been chosen, but I don’t get placed into the round), or even pills not dispensing to begin the round. 

This does beg the question: why not create a never-ending mode for single player?

In single player mode, the AI is also not the best player and eventually, after a couple of playthroughs, I learned its technique and could beat it every time.  

This does beg the question: why not create a never-ending mode for single player? Currently, the game ends when one of the players dies, so I never get past three rounds. This gets easily frustrating, especially once you figure out the rhythm of the game, making it an easy win that loses its Russian roulette element.   

Having a never-ending mode would easily solve this issue, as I could progress in rounds and play against different AIs. 

Another downside is also the reason why I can’t comment on the multiplayer version of the game. While trying to play a multiplayer game in online mode, there would occasionally be no rooms to join, or the rooms had players who knew each other and worked together to kill me off (cue the Among Us flashbacks).  

The art style was well-suited for the environment the developers were trying to create

So, if your friends do not get a copy of the game, it is almost impossible to enjoy it in multiplayer mode, and single player has its previously mentioned setbacks. 

Overall, I actually really enjoyed the aesthetics and gameplay mechanics of Side Effects. The art style was well-suited for the environment the developers were trying to create, and its simple controls make it perfect for players of any ability. 

I think, with a few tweaks, the single player mode can become as popular with players as the multiplayer mode is amongst groups of friends.