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Sanitarium is truly a masterful example of p'n'c adventures.
I could end it right there, if I so wish, but I won't. It would be unfair not to mention the fantastic elements of this one of a kind game.
The highlight of Sanitarium is most certainly the plot. From beginning to end, there is not a moment where you will not be (at least slightly) confused and possibly disgusted. After all, you are in a madhouse. Or inside your mind? Or inside your *minds*? Or something completely unexpected? I won't spoil anything, but I can say that the game, divided into chapters, is thought out and planned with care and reads like a good book. A good, terrifying book.
The game's production cost must have been high when it came out. All of the locations are pre-rendered, but done so beautifully. Characters are 2D sprites of high quality and detailed animation, fitting into their backgrounds perfectly. The art style fits the game's mood, and that's always a plus. Every bit of dialogue is voiced, including the thoughts of your protagonist, sometimes it's great, sometimes it's a bit lacking or cheesy. The music is somber, chilly and sometimes completely unexpected. There are lots of FMVs too, adding to the story.
The gameplay is standard p'n'c fare, in terms of collecting items, using items, solving puzzles, talking to characters and exploring locations. The difference between Sanitarium and other games in the genre is in structure: the game is divided into chapters, and each chapter is actually played on one single big screen. The screen is divided into closed and open areas - ie. standing in front of an open door will "open" the room to your view and slightly darken the outside. This completely eliminates any loading times in the chapters themselves, which is a huge thing for immersion.
The controls are a bit different too, everything is done with the mouse and its two buttons. The left one for interacting with objects/NPCs and holding the right one for movement in the direction you choose (ie. holding the right button and moving the mouse left will move your character left). The inventory is simple and appears by clicking on the protagonist: items appear in a circle around you, pointing over them brings up a description and clicking on them makes them usable with the environment.
NPC dialogues are done with topics. Talking to a character brings up a screen on the bottom with your picture and the NPC picture, with topics in the middle. Ie. talking about "You" will bring up the question "Who are you?" and so on. Talking about topics almost always brings up new topics. It's important to talk to everyone (and every...thing) because new topics appear a lot. A nice visual touch is that the pictures represent the mood of the protagonist (an angry face for rebuttals or a shocked face for revelations, etc.).
The puzzles themselves are mostly fairly logical, you just need to adapt to the certain chapter (like I said, I won't spoil anything). There's a decent amount of items and chances to use them, but not much (if at all) combining. It's important to note that everything needs to be examined first before you can use it/pick it up.
The only bad thing about Sanitarium might be its ending. I say 'might' because it's a personal preference. To me, it feels a bit rushed. The final puzzle is excellent and challenging, but the end leaves you wanting for a bit more. Some users also reported a few bugs, but nothing that can't be fixed with a few clicks on Support here on GOG. Other than that, you're in for a great and mad experience.
I wholeheartedly recommend this game. Definitely one of the best games in GOG's catalogue, dare I say it.