Ok, let me get this out of the way: I hate adventure games. Time is sparse, and when I finally do find time to play games during the week, the last thing I want to do is to waste 80% of my time being stuck in that game.
Nevertheless, Sanitarium got my attention and made be play through it despite these reservations. The setting appealed to me; you play as as a man with amnesia (and bandages on his face) who must puzzle-solve his way through numerous, increasingly bizarre and disturbing areas to find out about his past. This scary setting makes it stand out from the usual adventure game, the biggest parts of which seems to focus more on humour. E.g. a favourite area of mine comes early on when you must venture through a town with deformed kids (and their dead parents), only to find out that the place has been invaded by a nasty beast called "Mother".
Sanitarium is full of such areas which makes finding out the true nature of your predicament an interesting process. However, the mid-late game presents areas which are increasingly far-fetched to depict the characters failing sanity, full with metaphors related to real-life events which affects the main character. These areas are very sub-par compared to the early game, and I found myself wishing that the game would just be over already.
Because without the one thing this game has going for it - atmosphere- there is not much left to root for. The gameplay itself revolves around searching very limited areas in a top-down isometric perspective. While the 2D graphics are nice (freaggin love 2D graphics!) I doubt that the simple puzzles and mini-sized episodes will present much challenge for hardened adventure-game players. The real challenge often comes from finding one specific pixel somewhere in the level to acquire an item you need to continue. Moreover, the game is, as it usually the case with adventure titles, extremely linear and I doubt I will ever play it again.
To be fair, Sanitarium is an important game because it does something most games are too scared to do; tackle taboo subjects in a serious way. Of course, its effect does not come anywhere need Silent Hill 2 and 3 but it is still praise worthy. Also, the game has lot so of decently looking pre-rendered movies for the period (1997-98).
Yet, all aspects taken into account, I think "mediocre" is the most appropriate word I can utter about this game. It starts out strong with an interesting setting but ultimately runs out of cool ideas, blatantly exposing its simple puzzle gameplay and extremely limited game mechanics. Buy it if you can find it for cheap (GOG.com sometimes do sales).
**FOR MAC USERS**
I got this game running using Wineskin Winery - graphics and flickering but at least it runs.