The rate of SIDS have been steadily increasing over the last 20 years to the point where now some “developed” countries have infant (<2yo) mortality on par with 3rd world countries. SIDS has been baffling doctors, since no structural abnormalities have been found in SIDS victims and on average they appear more or less healthy, except for some of them exhibiting symptoms similar to autism. Another suggestive finding is that infants born to mothers using SSRI drugs during pregnancy have a higher chance of experiencing SIDS. The combination of these findings should have guided doctors towards exploring the 5-HT connection, however not much research has been done in that area yet. The few studies that have looked at the role of 5-HT in SIDS have all shown elevated 5-HT in plasma or platelets. The new study below found both to be the case – elevated 5-HT in plasma and platelets. Elevated 5-HT in plasma and platelets increases chance of blood clots, and it very well may be the case that a good portion of the SIDS victims expire due to occult stroke or another ischemic event. If elevated 5-HT is indeed the main cause of SIDS (and so far there is no evidence to suggest otherwise) then something as simple as cyproheptadine or famotidine (both approved for use in children, under medical supervision) may be able to prevent most SIDS cases. For people whose doctors balk at prescribing serotonin antagonists, aspirin may also be a good option, as it has also been shown to reduce plasma serotonin as well as increase its degradation into inactive metabolites such as 5-HIAA. Speaking of NSAID – it is important that the intervention is with aspirin, and not something like acetaminophen, as the latter has strong serotonergic effects and also decreases serotonin turnover/metabolism, so it can greatly increase the risk of SIDS. Unfortunately, most pediatricians are much more likely to approve Tylenol (acetaminophen) usage than they are to approve aspirin usage in infants.
https://www.miragenews.com/platelet-biomarkers-reveal-sids-risk-factors-1238665/
“…Researchers examined whether blood platelets, which have serotonin (5-HT) and 14-3-3 signaling pathways similar to brain neurons, are abnormal in sudden infant death syndrome (SIDS). About 40% of SIDS cases have abnormalities in serotonin and 14-3-3 pathways in brainstem areas related to hypoxia, gasping, and arousal. Whether platelets, which have similar serotonin and 14-3-3 pathways, are also abnormal in SIDS is unknown. In this study, researchers found platelets in postmortem blood from SIDS cases had significantly higher plasma and intra-platelet serotonin and lower intra-platelet 14-3-3 zeta and platelet surface glycoprotein IX (which is indirectly linked to 14-3-3) than controls. The presence in SIDS of both platelet and brainstem serotonin and 14-3-3 abnormalities suggest global dysregulation of these pathways. Platelet and plasma biomarkers may aid in the forensic determination of SIDS and have the potential to be predictive of SIDS risk in living infants.”
