S.E.M.I. – Side Effects May Include is a cooperative escape-style game that turns teamwork into unpredictable chaos. Developed and published by indie game studio Two Horn Unicorn, MKAU had the chance to check out the demo recently, and this title is unexpected and often messy, but that’s precisely what makes it stand out.

You and up to three other patients are trapped in a medical research facility, desperately trying to escape. There’s no traditional story, just a series of rooms that you need to escape, and it all ends with humorous “medical reports,” each mocking your poor decisions and incoordination. The narrative is light and relies on dark humour instead of depth, making every round feel like a short, self-contained sketch.

The goal is to escape the facility by solving puzzles, avoiding traps, and fighting guards with random weapons you can pick up along the way, such as a plunger, a suitcase, a fish, or a large soup ladle, and throwing objects like soccer balls and boxes of weights. Pills scattered around the map restore sanity (Health) but also grant unpredictable powers like shooting fireballs, lightning, or changing size through “Alice’s Syndrome.” Other effects like “Bipolar Force” or “Laser Astigmatism” make your abilities unreliable but entertaining.

You can also buy “medicine” from the vending machines between levels using lollipops you can collect within each level. Up to four players can join, and friendly fire keeps things interesting, especially when someone runs out of sanity and they’re bouncing around the room like a ricocheting cannonball.

The physics and controls are clumsy, but intentionally – they add to the unpredictability rather than working against the player.

There were a few bugs where someone would enter bouncing cannonball mode and get stuck too high in a wall or behind a door. We weren’t able to revive them without jumping on each other’s heads or trying to exploit the game in some way.

S.E.M.I. – Side Effects May Include uses a simple, cartoon art style, featuring clean hospital corridors and bright lighting. Pairing this art style with ragdoll physics is becoming increasingly popular in this space, and it consistently adds to fuelling the comedy. The sterile setting creates a good contrast to the chaos that players bring into it.

The audio design mirrors the game’s randomness. Ambient noises fill the hallways, and vending machines inexplicably play the Tetris theme (Is this copyright infringement?) Unfortunately, voice chat is inconsistent, sometimes barely audible, and sometimes peaks to the point where it becomes unusable.

S.E.M.I. – Side Effects May Include isn’t refined, but it doesn’t need to be. It’s a co-op escape game built around laughter, confusion, and unpredictable physics. Every session feels different, and the combination of strange powers, slapstick combat, and rough edges gives it a unique charm. It’s chaotic fun, best enjoyed with friends who don’t mind things going wrong.

Written by: Emily France