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I wouldn't say you need health pickups. The game is perfectly playable without them, and it does give the gameplay a unique flavor for a metroidvania. I didn't particularly dislike it.

It just seems weird to only take that survival horror-style approach for health pickups, while leaving in all the other usual drops from enemies you'd see in a Metroid game. An alternative where you only restock bombs, bullets etc at save points like it's Dark Souls could be pretty interesting.

my original intention was that pacing out save rooms and not letting the player heal inbetween could build tension, I was a big fan of how this balance played out in castlevania circle of the moon, in that game between save rooms is scary as fuck, but I think it kind of plays against the fast movement and almost punishes you for exploration in this case