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Ketamine Assisted EMDR Therapy™ for PTSD: investigating the synergistic effects of pharmacotherapy and psychotherapy

Michele Topel, Donald S. Ciccone

European Journal of Psychotraumatology November 4, 2025 DOI: 10.1080/20008066.2025.2572861 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Retrospective clinical chart review Randomized Peer reviewed
Sample size 8
Population Clients with PTSD in a private psychotherapy practice
Interventions Ketamine EMDR therapy
Dose 37.5-75 mg sublingual
Duration Four KA-EMDR reprocessing sessions
Measures International Trauma Questionnaire (ITQ)
Topics Ketamine Esketamine Psychedelic-assisted therapy PTSD
Keywords Memory consolidation Clinical psychology Psychotherapist Traumatic memories Pharmacotherapy Memory impairment Exposure therapy Modalities Posttraumatic stress
Citations 2
Key findings Ketamine Assisted EMDR Therapy significantly reduced PTSD symptom severity and functional impairment after four sessions.

Abstract

Background: Posttraumatic stress disorder (PTSD) is associated with maladaptive memory reconsolidation and overgeneralized fear responses. EMDR therapy promotes trauma reprocessing by activating the brain's intrinsic memory reconsolidation mechanism, facilitating memory updating, and abandoning outdated emotional schemas. Ketamine may also facilitate adaptive updating of traumatic memory due to its neurobiological and subjective effects. Research remains limited on the combined effects of EMDR therapy and ketamine for PTSD. Ketamine Assisted EMDR Therapy™ (KA-EMDR) integrates low-dose sublingual ketamine with EMDR memory reprocessing, providing a potentially synergistic trauma treatment by improving memory access, reducing hyperarousal, and enhancing adaptive reconsolidation of fear-based memories.Objective: To examine whether incorporating low-dose sublingual ketamine into EMDR therapy reduces PTSD symptom severity and functional impairment in individuals with PTSD.Methods: A retrospective clinical chart review examined data collected from eight clients with PTSD in a private psychotherapy practice who received KA-EMDR. Sublingual ketamine (37.5-75 mg) was self-administered during EMDR reprocessing after memory activation. The International Trauma Questionnaire (ITQ) assessed PTSD symptoms and functional impairment at baseline and after four KA-EMDR reprocessing sessions (T1). Paired-samples t-tests analysed symptom changes. Clients also completed a subjective experience questionnaire.Results: PTSD symptom scores significantly decreased from baseline (M = 15.50, SD = 2.98) to T1 (M = 9.88, SD = 4.94), t(7) = 3.21, p g = 1.01). Functional impairment scores significantly declined from baseline (M = 8.50, SD = 2.78) to TI (M = 5.25, SD = 3.24), t(7) = 2.60, p g = 0.82. Clients reported reduced fear, increased self-compassion and emotional clarity, less resistance, and minimal adverse effects.Conclusions: KA-EMDR may be a promising treatment for PTSD, particularly for those with treatment-resistant trauma. Larger randomized controlled studies are needed to confirm these findings.

Comparable studies

Other observational and cohort studies on ketamine for PTSD, most cited first.

Study Year Design Participants
Impact of oral ketamine augmentation on hospital admissions in treatment-resistant depression and PTSD: a retrospective study. Outpatients with treatment-resistant depression and PTSD 2018 Retrospective review n = 37
Ketamine-Assisted Psychotherapy Provides Lasting and Effective Results in the Treatment of Depression, Anxiety, and Post-Traumatic Stress Disorder at 3 and 6 Months: Findings from a Large Retrospective Effectiveness Study. Adults with a history of major depressive disorder, generalized anxiety disorder, or... 2024 Retrospective effectiveness study n = 346
Combined ketamine and psychotherapy provide no additional benefit beyond ketamine alone in treating depression or PTSD: Evidence from a help-seeking sample. Help-seeking individuals with depression and/or PTSD 2025 Observational cohort n = 624
Rapid and sustained reduction of treatment-resistant PTSD symptoms after intravenous ketamine in a real-world, psychedelic paradigm. Outpatients with elevated PTSD Checklist for DSM-5 scores 2025 Retrospective study n = 117
Ketamine treatment effects on DNA methylation and Epigenetic Biomarkers of aging Individuals with major depressive disorder or posttraumatic stress disorder 2024 Observational cohort n = 20

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