title: Urinary serotonin metabolite excretion during cisplatin chemotherapy.
abstract: BACKGROUND
  Nausea and vomiting associated with cisplatin chemotherapy is a source of major morbidity that remains difficult to control. Acute phase (0-24 hours after induction of chemotherapy) nausea and vomiting parallels plasma serotonin release, which explains the effectiveness of 5HT3 antagonists; serotonin release in the delayed phase (24-48 hours after induction), during which consistent antiemetic control remains elusive, has not been investigated. The effect of propofol, a recent addition to the antiemetic armamentarium, on this serotonin release has not been studied.
  
  
  METHODS
  Ten women with nausea and vomiting refractory to ondansetron and dexamethasone prophylaxis in their first cisplatin chemotherapy cycle were studied. Serial urinary 5-hydroxyindoleacetic acid (5-HIAA) levels were determined during a 48-hour period in 30 subsequent cycles, conducted under ondansetron/dexamethasone prophylaxis together with a propofol infusion.
  
  
  RESULTS
  There was a significant urinary 5-HIAA peak 6 hours after induction of chemotherapy, with no peaks thereafter. Propofol did not inhibit serotonin release.
  
  
  CONCLUSIONS
  Cisplatin chemotherapy is associated with serotonin release in the acute phase. There is no serotonin release during the delayed phase. Thus the use of 5HT3 antagonists for delayed-phase nausea and vomiting would appear questionable.
authors.affiliation: Department of Anaesthesiology, Geneva University Hospital, Switzerland.
authors.forename: O H
authors.initials: OH
authors.lastname: Wilder-Smith
authors.forename: A
authors.initials: A
authors.lastname: Borgeat
authors.forename: P
authors.initials: P
authors.lastname: Chappuis
authors.forename: M
authors.initials: M
authors.lastname: Fathi
authors.forename: M
authors.initials: M
authors.lastname: Forni
mesh_terms: D000328:Adult; D000368:Aged; D002945:Cisplatin / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006897:Hydroxyindoleacetic Acid / Q000652:urine*; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000652:urine; D012701:Serotonin / Q000378:metabolism; D013997:Time Factors; D014839:Vomiting / Q000139:chemically induced / Q000652:urine
chemical_list: D012701:Serotonin; D006897:Hydroxyindoleacetic Acid; D002945:Cisplatin