Emesis is a common side effect of chemotherapeutic drugs. Cisplatin, nitrogen mustard and dacarbazine induce increases in urinary 5-hydroxyindoleacetic acid (5-HIAA) in parallel with the development of the period of emesis which is sensitive to 5-HT<sub>3</sub> receptor antagonists (‘acute emesis’). It is suggested that these cytotoxics release serotonin from enterochromaffin cells, which then acts on 5-HT<sub>3 </sub>receptors to trigger the emetic response. Cyclophosphamide, on the other hand, induces a modest emetic response, partly sensitive to 5-HT<sub>3</sub> receptor antagonists, but not associated with increases in urinary 5-HIAA. It is suggested that cyclophosphamide-induced emesis is not mediated by the release of serotonin from enterochromaffin cells. Although after high-dose cisplatin most emesis is sensitive to 5-HT<sub>3</sub> receptor antagonists, patients often present a milder, although more prolonged form of emesis which is mostly resistant to 5-HT<sub>3</sub> receptor antagonists (also known as ‘delayed emesis’)- This form of emesis is not associated with increases in urinary 5-HIAA (not due to serotonin
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