{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T09:40:50Z","timestamp":1770716450210,"version":"3.49.0"},"reference-count":52,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>Serotonin reuptake inhibiting antidepressants decrease platelet aggregation. This may cause an increased risk of intracerebral hemorrhage. However, the risk of subclinical microbleeds, which are highly prevalent in middle-aged and elderly people, is unknown. We studied whether serotonin reuptake inhibiting antidepressants increase the frequency of cerebral microbleeds and secondarily whether they lower the presence of ischemic vascular damage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Within the population-based Rotterdam Study, information on antidepressant use was obtained from continuously monitored pharmacy records. Brain MRI was available in 4945 participants (55% women, mean age 64 years) between 2005 and 2011. We categorized antidepressants based on affinity for the serotonin transporter: high, intermediate, or low. Microbleeds (presence and location) and ischemic lesions (lacunes, white matter lesions) were rated on MRI. Logistic and linear regression, adjusted for age, sex, depressive symptoms, and cardiovascular risk were used to study the association of antidepressants with microbleeds and ischemic vascular lesions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>Antidepressant use with strong serotonin reuptake inhibition was not associated with microbleed presence (odds ratio compared with nonuse, 1.03; confidence interval, 0.75\u20131.39) irrespective of microbleed location in the brain. Exclusion of antithrombotic users or persons with cortical infarcts did not change our results. Furthermore, serotonin reuptake inhibition was not related to ischemic vascular brain damage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In the general population, use of serotonin reuptake inhibiting antidepressants is not related to presence of cerebral microbleeds. This strengthens the idea that the platelet inhibitor effects of antidepressant drugs with affinity for serotonin are minimal and further supports the safety of selective serotonin reuptake inhibitors for nongastrointestinal bleedings.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.114.004990","type":"journal-article","created":{"date-parts":[[2014,5,30]],"date-time":"2014-05-30T04:24:56Z","timestamp":1401423896000},"page":"1951-1957","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Inhibition of Serotonin Reuptake by Antidepressants and Cerebral Microbleeds in the General Population"],"prefix":"10.1161","volume":"45","author":[{"given":"Nikkie","family":"Aarts","sequence":"first","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saloua","family":"Akoudad","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Noordam","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"Hofman","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. Arfan","family":"Ikram","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruno H.","family":"Stricker","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loes E.","family":"Visser","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meike W.","family":"Vernooij","sequence":"additional","affiliation":[{"name":"From the Department of Internal Medicine (N.A., R.N., B.H.S., L.E.V.), Department of Epidemiology (N.A., S.A., R.N., A.H., M.A.I., B.H.S., L.E.V., M.W.V.), Department of Radiology (S.A., M.A.I., M.W.V.), and Department of Neurology (S.A., M.A.I.), Erasmus Medical Center, Rotterdam, the Netherlands; Inspectorate of Health Care, The Hague, the Netherlands (B.H.S.); and Apotheek Haagse Ziekenhuizen \u2013 HAGA, The Hague, the Netherlands (L.E.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-011-1054-z"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2008.03.009"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.55.4.310"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/10673220903129798"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7397.1014"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d4551"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1546"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-10-3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2010.240"},{"key":"e_1_3_3_11_2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1160\/TH03-05-0330","article-title":"The influence of selective serotonin reuptake inhibitors on human platelet serotonin.","volume":"91","author":"Maurer-Spurej E","year":"2004","unstructured":"Maurer-Spurej E, Pittendreigh C, Solomons K. The influence of selective serotonin reuptake inhibitors on human platelet serotonin. Thromb Haemost. 2004;91:119\u2013128.","journal-title":"Thromb Haemost"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2011.08.013"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2000.110456"},{"key":"e_1_3_3_14_2","first-page":"272","article-title":"Selective serotonin reuptake inhibitors and the risk of bleeding.","volume":"2","author":"Padma L","year":"2013","unstructured":"Padma L, Ranjani R, Rohini ST. Selective serotonin reuptake inhibitors and the risk of bleeding. Int J Basic Clin Pharmacol. 2013;2:272\u2013274","journal-title":"Int J Basic Clin Pharmacol"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.09r05786blu"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.0000018589.56991.ba"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1K369"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.1699"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.2000.00216.x"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2010.03797.x"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.107.491472"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.111.617043"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.436"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318271f848"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e3181dca10a"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0b013e31829c970e"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.111.000038"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.109.568469"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.579078"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneurol.2009.42"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000359"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(13)70060-7"},{"key":"e_1_3_3_33_2","first-page":"1","article-title":"The rotterdam study: 2014 objectives and design update.","author":"Hofman A","year":"2013","unstructured":"Hofman A, Murad S, Duijn C, Franco O, Goedegebure A, Arfan Ikram M, et al.. The rotterdam study: 2014 objectives and design update. Eur J Epidemiol. 2013:1\u201338","journal-title":"Eur J Epidemiol"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-011-9624-z"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.164.21.2367"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7314.655"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-2999(97)01393-9"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(01)01145-3"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bmcl.2004.04.066"},{"key":"e_1_3_3_40_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2481071158"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000307750.41970.d9"},{"key":"e_1_3_3_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2009.01.011"},{"key":"e_1_3_3_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2007.05.018"},{"key":"e_1_3_3_44_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.110.595181"},{"key":"e_1_3_3_45_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000154573.62822.89"},{"key":"e_1_3_3_46_2","doi-asserted-by":"publisher","DOI":"10.1177\/014662167700100306"},{"key":"e_1_3_3_47_2","doi-asserted-by":"publisher","DOI":"10.1093\/geronj\/46.6.M210"},{"key":"e_1_3_3_48_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-012-9668-8"},{"key":"e_1_3_3_49_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.111.626853"},{"key":"e_1_3_3_50_2","doi-asserted-by":"publisher","DOI":"10.1258\/ar.2011.110463"},{"key":"e_1_3_3_51_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e318271f8b6"},{"key":"e_1_3_3_52_2","first-page":"637","article-title":"Histopathologic analysis of foci of signal loss on gradient-echo T2*-weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds.","volume":"20","author":"Fazekas F","year":"1999","unstructured":"Fazekas F, Kleinert R, Roob G, Kleinert G, Kapeller P, Schmidt R, et al.. Histopathologic analysis of foci of signal loss on gradient-echo T2*-weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds. AJNR Am J Neuroradiol. 1999;20:637\u2013642.","journal-title":"AJNR Am J Neuroradiol"},{"key":"e_1_3_3_53_2","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.v65n1209"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.114.004990","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T14:29:04Z","timestamp":1715610544000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.114.004990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,7]]},"references-count":52,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2014,7]]}},"alternative-id":["10.1161\/STROKEAHA.114.004990"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.114.004990","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,7]]},"assertion":[{"value":"2014-01-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-04-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-05-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}