Adverse effects of Eye Movement Desensitization and Reprocessing therapy: A neglected but urgent area of inquiry

Abstract

While Eye Movement Desensitization and Reprocessing (EMDR) is widely recognized as an effective treatment for posttraumatic stress disorder (PTSD), its safety profile remains underexamined. This review critically evaluates the extent to which adverse effects are reported and monitored in EMDR research. We analyzed 51 randomized controlled trials from recent meta-analyses on EMDR for PTSD and found that only nine studies mentioned adverse effects, with just one employing systematic assessment protocols. In five of the nine studies, patients did report adverse effects, typically mild and temporary, but these were often described anecdotally and without predefined criteria or structured monitoring. Drop-out is more consistently reported across trials, but it is not a reliable indicator of adverse effects per se. The lack of structured monitoring of adverse effects complicates interpretation of EMDR's risk–benefit profile and limits informed decision-making in clinical settings. We discuss potential reasons for the underreporting of adverse events. Moreover, as EMDR is increasingly applied beyond PTSD, little is known about its safety in populations with complex comorbidities or in non-PTSD conditions. We also consider potential cognitive risks, such as memory blurring and the subsequent risk of false memory creation, though recent evidence suggests these effects are not robust or clinically concerning. To advance ethical and methodologically sound EMDR research, we propose integrating standardized adverse effects monitoring, preregistration of harm criteria, and safety endpoints alongside efficacy outcomes.