Side Effects: A Buckshot Roulette-inspired game about popping pills
Turn-based roulette games aren’t new, but they continue to be popular due to the development of interesting mechanics and the tense atmosphere that arises from testing your luck. The Side Effects game does just that, placing you in the medical hotseat with only experimental items at your disposal to help turn the tide against your opponents.
The Side Effects announcement gained a lot of traction because the game bears a resemblance to Buckshot Roulette. We’ve got the full breakdown of what you can expect from Side Effects at launch, along with the key comparison points between Side Effects and Buckshot Roulette.
What is Side Effects?
The Side Effects gameplay loop shares similarities with Buckshot Roulette, but pills are used as the basis of this turn-based medical roulette experience. Although Buckshot Roulette does have an eerie opponent and art style, Side Effects turns up the fear factor. The characters are creepy-looking patients, and the drugs affect them by adding spots and bruises to the skin and forming red eyes, for example. Side Effects also has a single-player mode against AI and supports multiplayer lobbies of up to four players. At launch, there will be an extended single-player mode and an endless mode to test how long you can survive as a test subject.
The Side Effects demo begins with you picking your items from a random set given to you. You select the items from your personal tray, and they then move to the playing area. The items range from Pliers that decrease other patients’ shields, a Replicator that can be used to gain two copies of a random patient’s item, a hammer that is used to destroy a pill, a Mint that can be consumed to end your turn, and more. Throughout the gameplay, you can see the resistance (shield) and health both you and your opponent have, as well as the items both of you own. Every pill impacts your resistance, which needs to be managed throughout the game
To begin a round, you dispense the pills, which will then fall on the playing table. Hovering over the pills will show how many are placebos and how many will lead to death when consumed. When it’s your turn, you can use your items and choose which pill you’re going to take. Every round, you can select from a new set of randomized items that Side Effects features. These are designed to help you progress as you get deeper in the game, and more pills with different effects will be deployed on the table as you make your way through the rounds.
The victory condition in the Side Effects video game is to outlive your opponents by any means necessary. Only one player can be the last one standing at the very end. The over 15 unique items in the full game can sway the odds in your favor against other players, and the six types of pills that can either help or hinder you.
When will Side Effects be released?
The full version of the Side Effects game will launch on November 21, 2025, and it will be playable on PC via Steam and Itch.io. The demo has already received an update based on player feedback. Various elements have been tuned, with the highlights being the Swap Item’s usage getting reduced from unlimited use to two uses, making the Eye Extractor more powerful, and increasing the consistency of the Coin Flip mechanic. The price for the game is yet to be revealed.
Who is the developer of Side Effects?
The developers of Side Effects are Hirohun, Mr.Pootsley, Jaybooty, Lofar42, with indie studio known as Free Lives. The Side Effects developer, Free Lives, has created a range of indie titles over the years that you may have heard of, like Terra Nil, Anger Foot, Stick it to the Stickman, and many more.
How long does it take to beat the Side Effects demo?
If you want a taste of what’s to come, you can play the demo, which contains a single-player mode, over ten items, and six different kinds of pills. There are plenty of mechanics on show here, and you can get acquainted with what’s on offer ahead of time. Therefore, the length of time it takes to beat the game depends on your strategy and how lucky you get with the randomized pills and items. Additionally, the Side Effects demo has a lot of replayability, so it has the potential to occupy you for hours.
How does Side Effects compare to Buckshot Roulette?
Side Effects is essentially Buckshot Roulette but with pills rather than a shotgun. In Buckshot Roulette, you are told how many live rounds and blank rounds are loaded into the shotgun, but the order they are placed in the chamber is random. Side Effects gambling in this way sees randomized pills as the central mechanic, with helpful and deadly pills remaining a mystery.
Buckshot Roulette has lives that must be managed and are represented by defibrillator charges. As for Side Effects, you must manage your health and your resistance against the side effects of various drugs in the game to survive. Both games make use of random items, with Buckshot Roulette featuring nine items, while Side Effects will have over 15. The items in Side Effects are all medical-themed to fit with the concept of pharmaceutical trials.
FAQs
If you enjoy turn-based roulette games, then the chances are that you will find fun in the Side Effects game.
Side Effects does have a multiplayer mode that supports two to four players in a game at once.
Side Effects is on PC and can be played on Steam and Itch.io.
Yes, Side Effects shares a lot of similarities with Buckshot Roulette. The main difference is that Side Effects is a medical roulette game using pills and medical items.
References
- SIDE EFFECTS — Demo Version 0.91 (Steam)
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