3-BENZYLAMINOPYRROLIDINES AND -PIPERIDINES AS TACHYKININ RECEPTOR ANTAGONISTS

Abstract: The present invention relates to compounds of formula (I) or a pharmaceutically acceptable salt or prodrug thereof, wherein R<1> is an optionally substituted 5- or 6-membered aromatic heterocyclic group containing 1,2,3 or 4 heteroatoms selected from nitrogen, oxygen and sulphur; R<2> and R<4> represent a variety of substituents; R<3> is H or C1-6alkyl; R<5> is H, halogen, C1-6alkyl, C1-6alkoxy substituted by C1-4alkoxy or CF3; R<6a> is H or C1-6alkyl; R<6b> is C1-6alkyl optionally substituted by a hydroxy group or the group -CO2R<c>, where R<c> is C1-6alkyl; R<9> is halogen, C1-6alkyl, oxo, CO2R<a> or CONR<a>R<b>; m is zero or 1; n is 1 or 2; and q is zero, 1 or 2. The compounds are of particular use in the treatment or prevention of pain, inflammation, migraine, emesis and postherpetic neuralgia.

Description: -BENZYLAMINOPYRROLIDINES AND -PIPERIDINES AS TACHYKININ RECEPTOR ANTAGONISTS This invention relates to a class of azacyclic compounds, which are 5 useful as tachykinm antagonists. More particularly, the compounds of the invention comprise an azacyclic ring system substituted by an aralkylamino moiety. The tachykinins are a group of naturally occurring peptides found widely distributed throughout mammalian tissues, both within the central 0 nervous system and in peripheral nervous and circulatory systems. The tachykinins are distinguished by a conserved carboxyl- erminal sequence: Phe-X-Gly-Leu-Met-NH 2 At present, there are three known mammalian tachykinins referred 5 to as substance P, neurokinin A (NKA, substance K, neuromedin L) and neurokinm B (NKB, neuromedin K) (for review see J.E. Maggio, Peptides (1985) 6(suppl. 3), 237-242). The current nomenclature designates the three tachykinm receptors mediating the biological actions of substance P, NKA and NKB as the NKi, NK 2 and NK. receptors, respectively. 0 Evidence for the usefulness of tachykinm receptor antagonists in pa , headache, especially migraine, Alzheimer's disease, multiple sclerosis, attenuation of morphine withdrawal, cardiovascular changes, oedema, such as oedema caused by thermal injury, chrome inflammatory diseases such as rheumatoid arthritis, asthma bronchial hyperreactivity 5 and other respiratory diseases including allergic rhinitis, inflammatory diseases of the gut including ulcerative colitis and Crohn's disease, ocular injury and ocular inflammatory diseases, proliferative vitreoretinopathy. irritable bowel syndrome and disorders of bladder function including cystitis and bladder detruser hyper-reflexia is reviewed in "Tachykinm 0 Receptors and Tachykinin Receptor Antagonists". C.A. Maggi, R Patacchini, P. Rovero and A. Giachetti, J. Auton. Pharmacol. (1993) 13, 23-93. For instance, substance P is believed inter alia to be involved in the neurotransmission of pain sensations [Otsuka et al, "Role of Substance P as a Sensory Transmitter in Spinal Cord and Sympathetic Ganglia" in 1982 Substance P in the Nervous System, Ciba Foundation Symposium 91, 13-34 (published by Pitman) and Otsuka and Yanagisawa, "Does Substance P Act as a Pain Transmitter?" TIPS (1987) 8, 506-510], specifically in the transmission of pain in migraine (B.E.B. Sandberg et al, J. Med Chem, (1982) 25, 1009) and in arthritis [Levme et al Science (1984) 226. 547-549]. Tachykinins have also been implicated in gastrointestinal (GI) disorders and diseases of the GI tract such as inflammatory bowel disease [Mantyh et al Neuroscience (1988) 25(3), 817-37 and D. Regoli in 'Υrends in Cluster Headache" Ed. Sicuteri et al Elsevier Scientific Publishers, Amsterdam (1987) page 85)] and emesis [F. D. Tattersall et al, Eur. J. Pharmacol., (1993) 250, R5-R6]. It is also hypothesised that there is a neurogenic mechanism for arthritis in which substance P may play a role [Kidd et al "A Neurogenic Mechanism for Symmetrical Arthritis" in The Lancet, 11 November 1989 and Grόnblad et al, "Neuropeptides in Synovmm of Patients with Rheumatoid Arthritis and Osteoarthπtis" in J. Rheumatol. (1988) 15(12), 1807-10]. Therefore, substance P is believed to be involved in the inflammatory response in diseases such as rheumatoid arthritis and osteoarthritis, and fibrositis [O'Byrne et al, Arthritis and Rheumatism (1990) 33, 1023-8]. Other disease areas where tachykinm antagonists are believed to be useful are allergic conditions [Hamelet et al. Can. J. Pharmacol. Physiol. (1988) 66, 1361-7], immunoregulation [Lotz et al. Science (1988) 241, 1218-21 and Kimball et al, J. Immunol. (1988) 141(10), 3564-9] vasodilation, bronchospasm, reflex or neuronal control of the viscera [Mantyh et al, PNAS (1988) 85. 3235-9] and, possibly by arresting or slowing β-amyloid-mediated neurodegenerative changes [Yankner et al, Science (1990) 250, 279-82] in senile dementia of the Alzheimer type, Alzheimer's disease and Down's Syndrome Tachykinm antagonists may also be useful in the treatment of small cell carcinomas, m particular small cell lung cancer (SCLC) [Langdon et al, Cancer Research (1992) 52, 4554-7]. Substance P may also play a role in demye nating diseases such as multiple sclerosis and amyotrophic lateral sclerosis [J. Luber-Narod et al, poster C.I.N.P. XVIIIth Congress, 28th June-2nd July 1992], and in disorders of bladder function such as bladder detrusor hyper-reflexia (Lancet, 16th May 1992, 1239) It has furthermore been suggested that tachykinins have utility in the following disorders- depression, dysthymic disorders, chronic obstructive airways disease, hypersensitivity disorders such as poison ivy, vasospastic diseases such as angina and Reynauld's disease, fϊbrosing and collagen diseases such as scleroderma and eosmophi c fasciohasis, reflex sympathetic dystrophy such as shoulder/hand syndrome, addiction disorders such as alcoholism, stress related somatic disorders, neuropathy, neuralgia, disorders related to immune enhancement or suppression such as systemic lupus erythmatosus (European patent specification no 0 436 334) ophthalmic disease such as conjuctivitis, vernal conjunctivitis and the like, and cutaneous diseases such as contact dermatitis, atopic dermatitis, urticaria, and other eczematoid dermatitis (European patent specification no 0 394 989). International Patent Specification no WO 95/08549 discloses piperidine derivatives as tachykinm receptor antagonists of the general formula wherein R lb is Cι-4alkoxy; R 2b is optionally substituted tetrazolyl; R 3b is hydrogen or halogen; R 4b and R 5b are hydrogen, halogen, C]. 4 alkyl. Ci 4alkoxy or CF 3 ; and x is zero or 1. The present invention provides a further class of non-peptides which are antagonists of tachykinins, especially of substance P. Thus, the present invention provides compounds of formula (I), and pharmaceutically acceptable salts and prodrugs thereof: R J (I) wherein R 1 represents a 5- or 6-membered aromatic heterocyc c group containing 1, 2, 3 or 4 heteroatoms selected from nitrogen, oxygen and sulphur, which is optionally substituted by one or two substituents, selected from Cι- 4 alkyl, C .. 7 cycloalkyl, C3-7cycloalkylCι-4alkyl, SR\ SOR x , SO 2 R\ phenyl, NR a R b , NR a COR x , CH2COCF3 and CF 3 , where R a and R b are independently hydrogen or Cι.4alkyl and R x is Cι-4alkyl; R 2 represents halogen, C_- 6 alkyl, Ci-βalkoxy, CF 3 , OCF 3 , NO 2 , CN, SR a , SOR a , SO 2 R a , CO 2 R a , CONR a R b , C 2 - 6 alkynyl or Cι_ 4 alkyl substituted by Cι- 4 alkoxy, where R a and R b each independently represent hydrogen or Ci alkyl; R 3 represents hydrogen or Ci ealkyl; R 4 represents hydrogen, halogen, Ci ealkyl, Ci.ealkoxy, hydroxy, CF 3 , NO 2> CN, SR a , SOR a , SO 2 R a , CO 2 R a , CONR a R b , C 2 .ealkenyl, C2 βalkynyl or Cι- 4 alkyl substituted by Cι- 4 alkoxy, where R a and R b each independently represent hydrogen or Cι. 4 alkyl; R 5 represents hydrogen, halogen, Ci.ealkyl, Ci-ealkoxy substituted by Ci 4 alkoxy or CF3; R Ga represents hydrogen or C_ (.alkyl; R 6b represents Cj ealkyl optionally substituted by a hydroxy group or the group -CO2R'", where R c represents Ci ealkyl, R 9 represents halogen, ealkyl, oxo, CO 2 R a or CONR a R b ; p is zero, 1 or 2; and q is zero, 1 or 2. As used herein, the definition of each expression when it occurs more than once in any structure, is intended to be independent of its definition elsewhere in the same structure. As used herein, the term "alkyl" or "alkoxy" as a group or part of a group means that the group is straight or branched. Examples of suitable alkyl groups include methyl, ethyl, n-propyl, i-propyl. n-butyl, s-butyl and t-butyl. Examples of suitable alkoxy groups include methoxy, ethoxy, n- propoxy, l-propoxy, n-butoxy, s-butoxy and t-butoxy The cycloalkyl groups referred to herein may represent, for example, cyclopropyl, cyclobutyl, cyclopentyl or cyclohexyl. A suitable cycloalkylalkyl group may be, for example, cyclopropylmethyl. As used herein, the terms "alkenyl" and "alkynyl" as a group or part of a group means that the group is straight or branched. Examples of suitable alkenyl groups include vinyl and allyl. A suitable alkynyl group is propargyl. When used herein the term halogen means fluorine, chlorine, bromine and iodine. The most apt halogens are fluorine and chlorine of which fluorine is preferred. The present invention includes within its scope prodrugs of the compounds of formula (I) above. In general, such prodrugs will be functional derivatives of the compounds of formula (I) which are readily convertible in υwo into the required compound of formula (I). Conventional procedures for the selection and preparation of suitable prodrug derivatives are described, for example, m "Design of Prodrugs", ed H. Bundgaard, Elsevier, 1985 The compounds according to the invention may exist both as enantiomers and as diastereomers In particular, the relative orientation of the 2- and 3- substituents on the azacyclic ring may give rise to cis and trans diastereoisomers, of which the cιs_ stereochemistry is preferred It is to be understood that all such isomers and mixtures thereof are encompassed within the scope of the present invention. Certain particularly apt compounds of the present invention include those wherein R 1 is a group selected from pyrrole, furan, thiene, pyπdine pyrazole, lmidazole, oxazole, isoxazole, thiazole, isothiazole, pyrazine nmιdιne. pyπdazme, tπazole, oxadiazole, thiadiazole, tπazme and tetrazole, each of which hetcroaryl groups being optionally substituted as previously defined - / Preferred compounds of the present invention are those wherein R 1 is a group selected from furan, pyridine, pyrazole, lmidazole, oxazole, isoxazole, pyrazme, pyrimidme, thiazole, 1,2,3-tπazole, 1,2,4-trιazole, 1,2,4-oxadiazole, 1,3,4-oxadιazole and tetrazole, each of which heteroarvl groups being optionally substituted as previously defined. Certain particularly apt compounds of the present invention include those wherein R 1 is a 5-membered aromatic heterocyclic group. Preferred compounds are those wherein R 1 is a 5-membered aromatic heterocyclic group containing 1, 2, 3 or 4 nitrogen atoms, for instance, where R 10 is hydrogen, Cι-4alkyl, C3 7cycloalkyl, C3 7cycloalkylCι 4 alkyl. SR\ SOR\ SO 2 R x , phenyl, NR a R b , NR a COR x , CH2COCF , or CF 3 , where R a and R b are independently hydrogen or Ci 4 alkyl, and R λ is Ci 4 alkyl Particularly preferred compounds of the present invention are those wherein R 1 is a group selected from where R 10 is as previously defined An especially preferred class of compound of formula (I) is that wherein R 1 is the group wherein R 10 is as previously defined. R 10 is preferably hydrogen, C]- 4 alkyl (especially methyl), ammo. Cι.4alkylammo (especially methylammo), di(Cι- 4 alkyl)amιno (especially dimethylammo or diethylamino), NC(O)Cι-4alkyl (especially NC(O)methyl), CH 2 C(O)CF3 or CF 3 . Most aptly R 2 is Ci 4 alkyl, Cι- 4 alkoxy, halogen, CF 3 or OCF 3 . Favourably R 2 is Cι-4alkoxy, halogen, CF3 or OCF3. More preferably R 2 is methoxy, ethoxy, propoxy, isopropoxy, fluorine, chlorine, CF3 or OCF3. Most preferably R 2 is in the meta- or para-position with respect to the group R 1 -(CH 2 ) m -. Most preferably R 2 is methoxy. Preferably R 3 is hydrogen or Cι-4alkyl. Most preferably, R 3 is hydrogen or methyl. Most aptly R 4 is hydrogen. Most aptly R 5 is hydrogen, fluorine, chlorine or CF3. Preferably R 4 is hydrogen and R 5 is hydrogen or 4-fluoro Suitable values for R (,d include hydrogen, methyl and ethyl Preferably R Ga is hydrogen or methyl, more preferably hydrogen. Preferably R Gb is Ci 4 alkyl optionally substituted by a hydroxy group, such as methyl, ethyl, CH 2 OH, CH2CH2OH, CH(OH)CH 3 or C(OH)(CH 3 ) 2 , or the group -CO 2 R c where R c is Ci .alkyl such as C(0)OCH Ϊ or C(0)OCH 2 CH 3 More preferably, R fib is methyl or CH2OH. When present, R 9 is preferably methyl. For the avoidance of doubt R is attached to any available carbon atom on the azacyclic ring Preferably m is zero. Preferably n is 2. Preferably p is zero or 1 Preferably q is zero. A particular sub-class of compounds according to the present invention is represented by compounds of formula (la), and pharmaceutically acceptable salts and prodrugs thereof: wherein R 1 , R 2 , R 3 , R 6b and p are as defined for formula (I) above; and A 1 is fluorine or hydrogen. Specific compounds within the scope of the present invention include: (±)-2,3-cιs-N-{l-[2-methoxy-5-(lH-tetrazol-l-yl)phenyl]ethy -2- phenylpιperιdm-3-amme; (±)-2,3-cιs-2-[(2-phenylpιperidin-3-yl)ammo]-2-[2-methoxy-5-(lH-tetrazol- l-yl)phenyl]ethanol; and pharmaceutically acceptable salts and prodrugs thereof. Further preferred compounds withm the scope of the present invention are described in the Examples described herein In a further aspect of the present invention, the compounds of formula (I) will preferably be prepared in the form of a pharmaceutically acceptable salt, especially an acid addition salt. For use in medicine, the salts of the compounds of formula (I) will be non-toxic pharmaceutically acceptable salts. Other salts may. however, be useful in the preparation of the compounds according to the invention or of their non-toxic pharmaceuticallv acceptable salts Suitable pharmaceutically acceptable salts of the compounds of this invention include acid addition salts which may, for example, be formed by mixing a solution of the compound according to the invention with a solution of a pharmaceutically acceptable acid such as hydrochloric acid, fumaric acid, p-toluenesulphonic acid, maleic acid, succinic acid, acetic acid, citric acid, tartaric acid, carbonic acid, phosphoric acid or sulphuric acid. Salts of amine groups may also comprise quaternary ammonium salts m which the amino nitrogen atom carries a suitable organic group such as an alkyl, alkenyl, alkynyl or aralkyl moiety Furthermore, where the compounds of the invention carry an acidic moiety, suitable pharmaceutically acceptable salts thereof may include metal salts such as alkali metal salts, e g sodium or potassium salts, and alkaline earth metal salts, e.g calcium or magnesium salts. The present invention includes withm its scope prodrugs of the compounds of formula (I) above. In general, such prodrugs will be functional derivatives of the compounds of formula (I) which are readily- convertible in viυo into the required compound of formula (I) Conventional procedures for the selection and preparation of suitable prodrug derivatives are described for example, in "Design of Prodrugs ed H Bundgaard, Elsevier, 1985 A prodrug mav be a pharmacologically inactive derivative of a biologically active substance (the parent drug ' or parent molecule") that requires transformation within the body in order to release the active drug, and that has improved delivery properties over the parent drug molecule The transformation in vivo may be, for example, as the result oi some metabolic process, such as chemical or enzymatic hydrolysis of a carboxy c, phosphoric or sulphate ester, or reduction or oxidation of a susceptible functionality Thus, for example certain preferred prodrugs mav not be antagonists of tachykinm particularly substance P activity to anv significant extent (or not at all). Such compounds, however, are still advantageous in treating the various conditions described herein. especially where an m ectable formulation is preferred. The advantages of a prodrug may lie in its physical properties, such as enhanced water solubility for parenteral administration compared with the parent drug, or it may enhance absorption from the digestive tract, or it may enhance drug stability for long-term storage. Ideally a prodrug will improve the overall efficacy of a parent drug, for example, through the reduction of toxicity and unwanted effects of drugs by controlling their absorption, blood levels, metabolism, distribution and cellular uptake. The present invention includes within its scope solvates of the compounds of formula (I) and salts thereof, for example, hydrates The compounds according to the invention have at least three asymmetric centres, and may accordingly exist both as enantiomers and as diastereoisomers. It is to be understood that all such isomers and mixtures thereof are encompassed within the scope of the present invention The preferred compounds of the formula (I) and(Ia) will have the 2- and 3- substituent cis and the preferred stereochemistry at the 2-posιtιon is 2-(S)- whilst the preferred stereochemistry of the 3-posιtιon is 3-(S) Thus for example as shown in formula (lb) R 1 R * (lb) The present invention further provides pharmaceutical compositions comprising one or more compounds of formula (I) in association with a pharmaceutically acceptable carrier. Preferably the compositions according to the invention are in unit dosage forms such as tablets, pills, capsules, powders, granules, solutions or suspensions, or suppositories, for oral, parenteral or rectal administration, or administration by inhalation or insufflation. For preparing solid compositions such as tablets, the principal active ingredient is mixed with a pharmaceutical carrier, e.g. conventional tableting ingredients such as corn starch, lactose, sucrose, sorbitol, talc, stearic acid, magnesium stearate, dicalcium phosphate or gums, and other pharmaceutical diluents, e.g. water, to form a solid preformulation composition containing a homogeneous mixture of a compound of the present invention, or a non-toxic pharmaceutically acceptable salt thereof. When referring to these preformulation compositions as homogeneous, it is meant that the active ingredient is dispersed evenly throughout the composition so that the composition may be readily subdivided into equally effective unit dosage forms such as tablets, pills and capsules. This solid preformulation composition is then subdivided into unit dosage forms of the type described above containing from 0.1 to about 500 mg of the active ingredient of the present invention. The tablets or pills of the novel composition can be coated or otherwise compounded to provide a dosage form affording the advantage of prolonged action. For example, the tablet or pill can comprise an inner dosage and an outer dosage component, the latter being in the form of an envelope over the former. The two components can be separated by an enteric layer which serves to lesist disintegration in the stomach and permits the inner component to pass intact into the duodenum or to be delayed in release. A variety of materials can be used for such enteric layers or coatings, such materials including a number of polymeric acids and mixtures of polymeric acids with such materials as shellac, cetyl alcohol and cellulose acetate. The liquid forms in which the novel compositions of the present invention may be incorporated for administration orally or bv injection include aqueous solutions, suitably flavoured syrups, aqueous or oil suspensions, and flavoured emulsions with edible oils such as cottonseed oil, sesame oil, coconut oil or peanut oil, as well as elixirs and similar pharmaceutical vehicles Suitable dispersing or suspending agents for aqueous suspensions include synthetic and natural gums such as tragacanth, acacia, alg ate, dextran, sodium carboxymethylcellulose, methylcellulose, polyvmyl-pyrro done or gelatin. Preferred compositions for administration by injection include those comprising a compound of formula (I), as the active ingredient, m association with a surface-active agent (or wetting agent or surfactant) or m the form of an emulsion (as a water-in-oil or oil-in-water emulsion) Suitable surface-active agents include anionic agents such as sodium bιs-(2-ethylhexyl)sulfosuccιnate (docusate sodium), cationic agents, such as alkyltnmethylammonium bromides, (e.g cetyltrimethylammomum bromide (cetrimide)), and in particular, non¬ ionic agents, such as polyoxyethylenesorbitans (e g Tween™ 20, 40, 60, 80 or 85) and other sorbitans (e.g. Span™ 20 40, 60 80 or 85) Compositions with a surface -active agent will conveniently comprise between 0 05 and 5% surface-active agent, and preferably between 0 1 and 2 5% It will be appreciated that other ingredients may be added, for example mannitol oi other pharmaceuticallv acceptable vehicles, if necessary Suitable emulsions may be prepared using commercial available fat emulsions, such as Intrahpid™, Liposyn™, Infonutrol™ Lipofundm™ and Lipiphysan™ The active ingredient mav be either dissol ed in a pre- mixed emulsion composition or alternatively it mav be dissolved in an oil (e g soybean oil, safflower oil, cottonseed oil, sesame oil corn oil or almond oil) and an emulsion formed upon mixing with a phosphohpid (e g egg phospholipids, soybean phosphohpids or sovbean lecithin) and water It will be appreciated that other ingredients may be added, for example glycerol or glucose, to adjust the tomcity of the emulsion. Suitable emulsions will typically contain up to 20% oil, for example, between 5 and 20% The fat emulsion will preferably comprise fat droplets between 0.1 and l.Oμm, particularly 0 1 and 0.5μm, and have a pH in the range of 5.5 to 8.0 Particularly preferred emulsion compositions are those prepared by mixing a compound of formula (I) with Intrahpid™ or the components thereof (soybean oil, egg phospho pids, glycerol and water). Compositions for inhalation or insufflation include solutions and suspensions m pharmaceutically acceptable, aqueous or organic solvents, or mixtures thereof, and powders. The liquid or solid compositions may contain suitable pharmaceutically acceptable excipients as set out above. Preferably the compositions are administered by the oral or nasal respiratory route for local or systemic effect. Compositions in preferably sterile pharmaceutically acceptable solvents may be nebulised by use of inert gases. Nebulised solutions may be breathed directly from the nebulising device or the nebulising device may be attached to a face mask, tent or intermittent positive pressure breathing machine Solution, suspension or powder compositions may be administered, preferably orally or nasally, from devices which deliver the formulation an appropriate manner The present invention futher provides a process for the preparation of a pharmaceutical composition comprising a compound of formula (I), which process comprises bringing a compound of formula (I) into association with a pharmaceutically acceptable carrier or excipient The compounds of formula (I) are of value in the treatment of a wide variety of clinical conditions which are characterised bv the presence of an excess of tachykinm. m particular substance P, activit \ Thus, for example, an excess of tachykinm, and in particular substance P, activity is implicated in a variety of disorders of the central nervous system Such disorders include mood disorders such as depression or more particularly depressive disorders, for example single episodic or recurrent major depressive disorders and dysthymic disorders, or bipolar disorders, for example, bipolar I disorder, bipolar II disorder and cyclothymic disorder; anxiety disorders, such as panic disorder with or without agoraphobia, agoraphobia without history of panic disorder, specific phobias, for example, specific animal phobias, social phobias, obsessive-compulsive disorder, stress disorders including post-traumatic stress disorder and acute stress disorder, and generalised anxiety disorders; schizophrenia and other psychotic disorders, for example, schizophreniform disorders, schizoaffective disorders, delusional disorders, brief psychotic disorders, shared psychotic disorders and psychotic disorders with delusions or hallucinations, delenum, dementia, and amnestic and other cognitive or neurodegenerative disorders, such as Alzheimer's disease, senile dementia, dementia of the Alzheimer s type, vascular dementia, and other dementias, for example, due to HIV disease, head trauma, Parkinson's disease, Huntmgton's disease, Pick's disease, Creutzfeldt-Jakob disease, or due to multiple aetiologies, Parkinson's disease and other extra-pyramidal movement disorders such as medication-mduced movement disorders, for example, neuroleptic-induced parkmsonism, neuroleptic malignant syndrome, neuroleptic-induced acute dystoma, neuroleptic- duced acute akathisia, neuroleptic-mduced tardive dvskinesia and medication-mduced postural tremoui, substance-i elated disorders arising from the use of alcohol, amphetamines (or amphetamme- hke substances) caffeine, cannabis, cocaine, hallucinogens, inhalants and aerosol propellants, nicotine, opioids, phenylglycidme derivatives sedatives hypnotics, and anxiolytics, which substance-related disorders include dependence and abuse, intoxication withdrawal, intoxication delenum, withdrawal delenum, persisting dementia psychotic disorders mood disorders, anxiety disorders, sexual dysfunction and sleep disorders epilepsy, Down's syndrome, demyelmatmg diseases such as MS and ALS and other neuropathological disorders such as peripheral neuropathv for example diabetic and chemotherapy-mduced neuropathy, and postherpetic neuralgia, tngemmal neuralgia, segmental or intercostal neuralgia and other neuralgias; and cerebral vascular disorders due to acute or chronic cerebrovascular damage such as cerebral infarction, subarachnoid haemorrhage or cerebral oedema Tachykinm, and in particular substance P, activity is also involved in nociception and pain The compounds of the present invention will therefore be of use in the prevention or treatment of diseases and conditions in which pam predominates, including soft tissue and peripheral damage, such as acute trauma, osteoarthntis, rheumatoid arthritis, musculo-skeletal pain, particularly after trauma, spmal pam, dental pain, myofascial pam syndromes, headache, episiotomy pam, and burns; deep and visceral pain, such as heart pam, muscle pam, eye pam, orofacial pain, for example, odontalgia, abdominal pain, gynaecological pain, for example, dysmenorrhoea, and labour pain; pain associated with nerve and root damage, such as pam associated with peripheral nerve disorders, for example, nerve entrapment and brachial plexus avulsions, amputation, peripheral neuropathies, tic douloureux, atypical facial pam, nerve root damage, and arachnoiditis; pain associated with carcinoma, often referred to as cancer pam, central nervous system pam such as pam due to spmal cord or bram stem damage, low back pam; sciatica, ankylosmg spondyhtis, gout; and scar pam Tachykinm, and in particular substance P, antagonists mav also be of use in the treatment of respiratory diseases, particularly those associated with excess mucus secretion, such as chronic obstructive airways disease, bronchopneumonia, chronic bronchitis, cystic fibrosis and asthma, adult respiratory distress syndrome, and bronchospasm inflammatory diseases such as inflammatory bowel disease, psoriasis, fibrositis, osteoarthntis, rheumatoid arthritis, pruπtis and sunburn, allergies such as eczema and rhinitis; hypersensitivity disorders such as poison ivy, ophthalmic diseases such as conjunctivitis vernal conjunctivitis, and the like; ophthalmic conditions associated with cell proliferation such as pro ferative vitreoretinopathy; cutaneous diseases such as contact dermatitis, atopic dermatitis, urticaria, and other eczematoid dermatitis Tachykinm, and m particular substance P, antagonists may also be of use in the treatment of neoplasms, including breast tumours, neurogang oblastomas and small cell carcinomas such as small cell lung cancer Tachykinm, and m particular substance P, antagonists may also be of use in the treatment of gastrointestinal (GI) disorders, including inflammatory disorders and diseases of the GI tract such as gastritis, gastroduodenal ulcers, gastric carcinomas, gastric lymphomas, disorders associated with the neuronal control of viscera, ulcerative colitis, Crohn's disease, irritable bowel syndrome and emesis, including acute, delayed or anticipatory emesis such as emesis induced by chemotherapy, radiation, toxms, viral or bacterial infections, pregnancy, vestibular disorders, for example, motion sickness, vertigo, dizziness and Memere's disease, surgery, migraine, variations in mtercranial pressure, gastro-oesophageal reflux disease, acid indigestion, over indulgence in food or drink, acid stomach, waterbrash or regurgitation, heartburn, for example, episodic, nocturnal or meal-induced heartburn, and dyspepsia Tachykinm, and in particular substance P, antagonists may also be of use in the treatment of a variety of other conditions including stress related somatic disorders, reflex sympathetic dystrophy such as shoulder/hand syndrome; adverse immunological reactions such as rejection of transplanted tissues and disorders related to immune enhancement or suppression such as systemic lupus ervthematosus, plasma extravasation resulting from cytokme chemotherapy, disorders of bladder function such as cystitis, bladder detrusor hyper-reflexia and incontinence; fibrosmg and collagen diseases such as scleroderma and oosinophilic fascioliasis, disorders of blood flow caused by vasodilation and vasospastic diseases such as angina, vascular headache, migraine and Reynaud's disease, and pain or nociception attributable to or associated with any of the foregoing conditions, especially the transmission of pam m migraine. The compounds of formula (I) are also of value in the treatment of a combination of the above conditions, in particular m the treatment of combined post-operative pam and post-operative nausea and vomiting. The compounds of formula (I) are particularly useful in the treatment of emesis, including acute, delayed or anticipatory emesis, such as emesis induced by chemotherapy, radiation, toxins, pregnancy, vestibular disorders, motion, surgery, migraine, and variations m mtercranial pressure Most especially, the compounds of formula (I) are of use in the treatment of emesis induced by antmeoplastic (cytotoxic) agents, including those routinely used in cancer chemotherapy, and emesis induced by other pharmacological agents, for example, rohpram Examples of such chemotherapeutic agents include alkylating agents, for example, nitrogen mustards, ethyleneimme compounds, alkyl sulphonates and other compounds with an alkylating action such as nitrosoureas, cisplatin and dacarbazme; antimetabolites, for example folic acid, p urine or pyrimidme antagonists, mitotic inhibitors, for example, vinca alkaloids and derivatives of podophyllotoxin, and cytotoxic antibiotics Particular examples of chemotherapeutic agents are described, foi instance, by D J Stewart in Nausea and Vomiting Recent Research and Clinical Advances, Eds J Kucharczyk et al, CRC P ess Inc Boca Raton Florida, USA (1991) pages 177-203, especially page 188 Commonly used chemotherapeutic agents include cisplatin, dacarbazme (DTIC) dac inomycin, mechlorethamme (nitrogen mustard) streptozocin cyclophosphamide, carmustme (BCNU), lomustine (CCNU) doxorubicm (adπamycin), daunorubicm, procarbazme, mitomycm cvtarabme etoposide methotrexate, 5-fluorouracιl, vinblastine \ lncπstinc bleomvc and chlorambucil [R. J. Gralla et al in Cancer Treatment Reports (1984) 68(1). 163-172]. The compounds of formula (I) arc also of use in the treatment of emesis induced by radiation including radiation therapy such as in the treatment of cancer, or radiation sickness; and in the treatment of post¬ operative nausea and vomiting. It will be appreciated that the compounds of formula (I) may be presented together with another therapeutic agent as a combined preparation for simultaneous, separate or sequential use for the relief of emesis. Such combined preparations may be, for example, in the form of a twin pack. A further aspect of the present invention comprises the compounds of formula (I) in combination with a 5-HT 3 antagonist, such as ondansetron, granise tron or tropisetron, or other anti-emetic medicaments, for example, a dopamme antagonist such as metoclopramide or GABAB receptor agonists such as baclofen. Additionally, a compound of formula (I) may be administered in combination with an anti- mflammatory corticosteroid, such as dexamethasone, tπamcmolone. tπamcinolone acetomde, flunisohde. budesonide, or others such as those disclosed in US patent nos. 2,789,118, 2,990,401. 3.048.581, 3.126.375. 3,929,768, 3,996,359, 3,928,326 and 3,749,712. Dexamethasone (Decadron™) is particularly preferred. Furthermore, a compound of formula (I) may be administered m combination with a chemotherapeutic agent such as an alkylating agent, antimetabohte, mitotic inhibitor or cytotoxic antibiotic, as described above. In general, the currently available dosage forms of the known therapeutic agents for use in such combinations will be suitable. When tested in the ferret model of cisplatin-induced emesis described by F. D. Tattersall et al, in Eur. J. pharmacoi. (1993) 250. R5- R6, the compounds of the present invention were found to attenuate the retching and vomiting induced by cisplatin. The compounds of formula (I) are also particularly useful in the treatment of pain or nociception and/or inflammation and disorders associated therewith such as, for example, neuropathy, such as diabetic and chemotherapy-mduced neuropathy, postherpetic and other neuralgias, asthma, osteroarthntis, rheumatoid arthritis, headache and especially migraine The present invention further provides a compound of formula (I) for use in therapy According to a further or alternative aspect, the present invention provides a compound of formula (I) for use in the manufacture of a medicament for the treatment of physiological disorders associated with an excess of tachykinins, especially substance P The present invention also provides a method for the the treatment or prevention of physiological disorders associated with an excess of tachykinins, especially substance P, which method comprises administration to a patient m need thereof of a tachykinm reducing amount of a compound of formula (I) or a composition comprising a compound of formula (I) For the treatment of certain conditions it may be desirable to employ a compound according to the present invention in conjunction with another pharmacologically active agent For example, for the treatment of respiratory diseases such as asthma, a compound of formula (I) may be used in conjunction with a bronchodilator, such as a β 2 -adrenergιc receptor agonist or tachykinm antagonist which acts at NK-2 receptors The compound of formula (I) and the bronchodilator mav be administered to a patient simultaneously, sequentially or in combination Likewise, a compound of the present invention may be employed with a leukotnene antagonists, such as a leukotπene D t antagonist such as a compound selected from those disclosed in European patent specification nos 0 480 717 and 0 604 114 and in US patent nos 4 859,692 and 5,270,324 This combination is particularly useful in the treatment of respiratory diseases such as asthma, chronic bronchitis and cough The present invention accordingly provides a method for the treatment of a respiratory disease, such as asthma, which method comprises administration to a patient m need thereof of an effective amount of a compound of formula (I) and an effective amount of a bronchodilator. The present invention also provides a composition comprising a compound of formula (I), a bronchodilator, and a pharmaceutically acceptable carrier. It will be appreciated that for the treatment or prevention of migraine, a compound of the present invention may be used in conjunction with other anti-migrame agents, such as ergotamines or 5-HT_ agonists, especially sumatnptan, naratriptan, zolmatnptan or rizatriptan. Likewise, for the treatment of behavioural hyperalgesia, a compound of the present invention may be used in conjunction with an antagonist of N-methyl D-aspartate (NMDA), such as dizocilpme. For the treatment or prevention of inflammatory conditions m the lower urinary tract, especially cystitis, a compound of the present invention may be used m conjunction with an antimflammatory agent such as a bradykmm receptor antagonist It will be appreciated that for the treatment or prevention of pam or nociception, a compound of the present invention may be used m conjunction with other analgesics, such as acetaminophen (paracetamol), aspirin and other NSAIDs and, in particular, opioid analgesics, especially morphine Specific anti-inflammatory agents include diclofenac, lbuprofen, lndomethacm, ketoprofen, naproxen piroxicam and sulmdac Suitable opioid analgesics of use in conjunction with a compound of the present invention include morphine, codeine, dihydrocodeme, diacetylmorphme, hvdrocodone, hydromorphone, levorphanol oxymorphone, alfentanil, buprenorphme, butorphanol fentanyl, sufentanyl, meperidme, methadone, nalbuphine, propoxyphene and pentazocme; or a pharmaceutically acceptable salt thereof Preferred salts of these opioid analgesics include morphine sulphate, morphine hydrochlo de, morphine tartrate, codeine phosphate, codeine sulphate, dihydrocodeine bitartrate, diacetylmorphine hydrochlonde, hydrocodone bitartrate, hydromorphone hydrochlonde, levorphanol tartrate, oxymorphone hydrochlonde, alfentanil hydrochlonde, buprenorphine hydrochlonde, butorphanol tartrate, fentanyl citrate, meperidme hydrochlonde, methadone hydrochlonde, nalbuphine hydrochlonde, propoxyphene hydrochlonde, propoxyphene napsylate (2-naphthalenesulphonιc acid (1 1) monohydrate), and pentazocme hydrochlonde. Therefore, in a further aspect of the present invention, there is provided a pharmaceutical composition comprising a compound of the present invention and an analgesic, together with at least one pharmaceutically acceptable carrier or excipient In a further or alternative aspect of the present invention, there is provided a product comprising a compound of the present invention and an analgesic as a combined preparation for simultaneous separate or sequential use in the treatment or prevention of pain or nociccp tion It will be appreciated that for the treatment of depression or anxiety, a compound of the present invention may be used m conjunction with other anti-depressant or anti-anxiety agents Suitable classes of anti-depressant agent include norepmephrme leuptake inhibitors, selective serotonin re uptake inhibitors (SSRIs) monoamme oxidase inhibitors (MAOIs) reversible inhibitors of monoamine oxidase (RIMAs) serotonin and noradrenalme reuptake inhibitors (SNRIs), corticotropm releasing factor (CRF) antagonists α- adrenoreceptor antagonists and atypical anti-depressants Suitable norepmephrme reuptake inhibitors include tertiarv amine tricyclics and secondary amme tricvchcs Suitable examples of tertiary amme tricyc cs include: amitriptyline, clomipramine, doxepin, imipramme and tnmipramme, and pharmaceutically acceptable salts thereof. Suitable examples of secondary amine tricychcs include: amoxapme, desipramine, maprotiline, nortriptyline and protriptyline, and pharmaceutically acceptable salts thereof. Suitable selective serotonin reuptake inhibitors include: fluoxetine, fluvoxamine, paroxetine and sertr aline, and pharmaceutically acceptable salts thereof. Suitable monoamine oxidase inhibitors include: isocarboxazid, phenelzine, tranylcypromine and selegiline, and pharmaceutically acceptable salts thereof. Suitable reversible inhibitors of monoamine oxidase include: moclobemide, and pharmaceutically acceptable salts thereof. Suitable serotonin and noradrenaline reuptake inhibitors of use in the present invention include: venlafaxine, and pharmaceutically acceptable salts thereof. Suitable CRF antagonists include those compounds described in International Patent Specification Nos. WO 94/13643, WO 94/13644, WO 94/13661, WO 94/13676 and WO 94/13677. Suitable atypical anti-depressants include: bupropion. lithium, nefazodone, trazodone and viloxazme, and pharmaceutically acceptable salts thereof. Suitable classes of anti-anxiety agent include benzodiazepmes and 5-HTι \ agonists or antagonists, especially 5-HTIΛ partial agonists, and corticotropin releasing factor (CRF) antagonists. Suitable benzodiazepmes include: alprazolam. chlordiazepoxide, clonazepam, chlorazepate, diazepam. halazepam. lorazepam. oxazepam and prazepam. and pharmaceutically acceptable salts thereof. Suitable 5-HTIΛ receptor agonists or antagonists include, in particular, the 5-HTι \ receptor partial agonists buspirone. flesinoxan, gepirone and lpsaperone. and pharmaceutically acceptable salts thereof. Therefore, in a further aspect of the present invention, there is provided a pharmaceutical composition comprising a compound of the present invention and an anti-depressant or anti-anxiety agent, together with at least one pharmaceutically acceptable carrier or excipient. In a further or alternative aspect of the present invention, there is provided a product comprising a compound of the present invention and an anti-depressant or anti-anxiety agent as a combined preparation for simultaneous, separate or sequential use for the treatment or prevention of depression and/or anxiety. The excellent pharmacological profile of the compounds of the present invention offers the opportunity for their use in therapy at low doses thereby minimising the risk of unwanted side effects. In the treatment of the conditions associated with an excess of tachykinins, a suitable dosage level is about 0.001 to 50 mg/kg per day, in particular about 0.01 to about 25 mg/kg, such as from about 0.05 to about 10 mg/kg per day. For example, in the treatment of conditions involving the neurotransmission of pain sensations, a suitable dosage level is about 0.001 to 25 mg/kg per day, preferably about 0.005 to 10 mg/kg per day, and especially about 0.005 to 5 mg/kg per day. The compounds may be administered on a regimen of 1 to 4 times per day, preferably once or twice per day. In the treatment of emesis using an injectable formulation, a suitable dosage level is about 0.001 to 10 mg/kg per day, preferably about 0.005 to 5 mg/kg per day, and especially 0.01 to 2 mg/kg per day. The compounds may be administered on a regimen of 1 to 4 times per day. preferably once or twice per day. It will be appreciated that the amount of a compound of formula (I) required for use in any treatment will vary not only with the particular compounds or composition selected but also with the route of administration, the nature of the condition being treated, and the ace and condition of the patient, and will ultimately be at the discretion of the attendant physician. The compounds according to the present invention may be prepared by a process (A) which comprises reacting a compound of formula (II) with a compound of formula (III): (ID (III) wherein R 1 , R 2 , R 4 , R 5 , R 6a , R Gb , R 9 m, n, p and q are as defined for formula (I), except that any reactive moiety is protected by a suitable protecting group; and one of R 30 and R 31 represents a leaving group and the other of R 30 and R 31 represents NHR 3 , where R 3 is as defined for formula (I); the presence of a base, followed by deprotection, if required. Suitably R 30 represents NHR 3 and R 31 represents a leaving group. Suitable leaving groups include halogen atoms, e.g. chlorine. bromine or iodine, or sulphonate derivatives such as tosylate, mesylate or triflate. The reaction is conveniently carried out in a suitable organic solvent, such as an ether, e.g. 1,2-dιmethoxyethane, at a temperature in the region of 0°C. Favoured bases of use in the reaction include alkali metal amides and hydrides, such as potassium bιs(tπmethylsιlyl)amιde or potassium hydride. Suitably, sodium hydride is used. According to another process (B), compounds of formula (I) wherein R 6a is hydrogen, may be prepared by the reductive animation of a compound of formula (II) in which R 30 is the group NHR 3 , with a compound of formula (IV), in the presence of a reducing agent: (IV) Suitable reducing agents for use in this reaction include, for example, sodium cyanoborohydride or sodium triacetoxyborohydride, or catalytic hydrogenation. The reaction is conveniently effected in a suitable solvent such as acetic acid or methanol at a temperature between 0°C and 50°C, conveniently at about room temperature. According to another general process (C), compounds of formula (I) wherein m is zero and R 1 is a tetrazol-1-yl group substituted by a 5-amino moiety may be prepared by reaction of intermediates of formula (V) R D (V) with ammonium chloride and sodium azide at elevated temperature. conveniently in a solvent such as dimethylformamide. According to another general process (D), compounds of formula (I) may be prepared by a coupling reaction between a compound of formula (Λ ~ I) and (VII) R° (VI) (VII) wherein one of R 40 and R 41 is B(OH) 2 or Sn(alkyl)3 or a derivative thereof, and the other is a leaving group such as a halogen atom e.g. bromine or iodine, or -OSO2CF3. Where one of R 40 and R 41 is B(OH) 2 , the reaction is conveniently effected m the presence of a palladium (0) catalyst such as tetrakιs(triphenylphosphine)palladιum (0) in a suitable solvent such as an ether, for example, dimethoxyethane at an elevated temperature. Where one of R 40 and R 41 is Sn(alkyl) 3 , the reaction is conveniently effected in the presence of palladium (II) catalyst such as bιs(tπphenylphosphme) palladium (II) chloride, in a suitable solvent such as an aromatic hydrocarbon, for example, toluene, at an elevated temperature. According to another general process (E), compounds of formula (I) may be prepared by reduction of a compound of formula (VIII) (with the proviso that R π is not oxo). Suitable reducing agents will be readily apparent to one skilled in the art and include, for example, borane or metallic hydrides, such as lithium aluminium hydride or sodium borohydride. Borane is preferred. Further details of suitable procedures will be found in the accompanying Examples. Compounds of formula (VIII) may be prepared by reductive amination of a compound of formula (IX) wherein any reactive moiety is protected by a suitable protecting group using, for example, sodium cyanoborohydπde or sodium tπacetoxyborohydride and a compound of the formula (III) in which R 31 is a leaving group such as a halogen atom, for example, a bromine atom. The reaction is effected in the presence of a base, for example, potassium carbonate and in a suitable solvent such as dimethylformamide. It will be appreciated that the product of the reductive animation method described herein will be a mixture of stereoisomers at the position of the group R 6a . For the subsequent preparation of a specific isomer of a compound of formula (I) wherein R 6a is hydrogen and R 6b is, for example, Ci-βalkyl, the mixture of stereoisomers may be resolved by conventional methods, for example, by column chromatography. Methods for the preparation of intermediates of formula (IX) and formula (II) when R 30 is NHR 3 are described, for example, in European Patent Specification No. 0 436 334. Where they are not commercially available, the intermediates of formulae (III), (IV) and (VII) above may be prepared by procedures which will be readily apparent to one skilled in the art, for instance, using methodology such as that described in International Patent Specification No. WO 95/08549, published 30th March 1995. Intermediates of formula (VI) may be prepared by method analogous to those described herein Where the above-described processes for the preparation of the compounds according to the invention give rise to mixtures of stereoisomers these isomers may, if desired, be separated, suitably by conventional techniques such as preparative chromatography The novel compounds may be prepared m racemic form, or individual enantiomers may be prepared either by enantiospecific synthesis or by resolution. For example, compounds which contain a hydroxy group may be resolved into their component enantiomers by standard techniques, such as the formation of diastereomenc esters or amides followed by chromatographic separation or separation by fractional crystallization and removal of the chiral auxiliary Where they are intermediates, diastereomenc alcohols can then be used to prepare optically pure compounds of formula (I). During any of the above synthetic sequences it may be necessary and/or desirable to protect sensitive or reactive groups on any of the molecules concerned. This may be achieved by means of conventional protecting groups, such as those described in Protective Groups in Organic Chemistry, ed. J.F.W. McOmie, Plenum Press, 1973; and T.W. Greene and P.G.M. Wuts, Protective Groups in Organic Synthesis, John Wiley & Sons, 1991. The protecting groups may be removed at a convenient subsequent stage using methods known from the art. Tachykinin antagonist activity for compounds of the present invention may be demonstrated by the methods set out at pages 36 to 39 of International Patent Specification No. WO 93/01165. The compounds of this invention may be formulated as specifically illustrated at pages 35 to 36 of International Patent Specification No. WO 93/01165. The following Examples illustrate the preparation of compounds according to the invention. EXAMPLE 1 (±)-2.3-cts-/V r -{l-r2-Methoxy-5-(lH-tetrazol-l -yl)phenyllethyl)-2- phenylpιperιdin-3-amme dihvdrochloride (i) N-(3-Acetyl-4-methoxyphenyl)acetamιde Methyl iodide (3.42ml, 7.81g, 55mmol) was added to a stirred mixture of -(3-acetyl-4-hydroxyphenyl)acetamide (J.Org.Chem. 1995, 60. 4324-4330) (9.65g, 50mmol) and potassium carbonate (13.82g, lOOmmol) m dimethylformamide (50ml). The mixture was stirred at room temperature for 72 hours, then the solvent was evaporated under reduced pressure. Water (100ml) was added and the mixture was extracted with ethyl acetate (6 x 100ml). The combined organic fractions were dried (MgSO i) and evaporated under reduced pressure to give N-(3-a cetyl-4- methoxyphenyl)acetamιde as a tan solid (10.34g. 100%), 'H NMR (de-DMSO) δ 9.91 (1H, br. s), 7.76 (2H, m), 7.12 (1H, d, J=9.6Hz). 3.86 (3H, s), 2.52 (3H, s), and 2.01 (3H, s). m/e (CI + ) 208 (MH + ). (ii) l-(5-Ammo-2-methoxyphenyl)ethanone Hydrochloric acid (6M, 50ml) was added to a mixture of N-(3-acetyl-4- methoxyphenyl)acetamide (10.34g, 50mmol) and ethanol (150ml) and the mixture was stirred under reflux for 8 hours. The mixture was cooled and the solvent was evaporated under reduced pressure. Water (100ml) was added and the pH was adjusted to 10.0 with saturated aqueous potassium carbonate. The mixture was extracted with dichloromethane (3 x 100ml) and the combined organic fractions were dried (MgSO4) and evaporated under reduced pressure to give l-(5-ammo-2-methoxyphenyl)ethanone as a dark oil (8.16g, 99%), Η NMR (CDCI3) δ 7.09 (1H, d, J=2.8Hz), 6.82 (2H, m), 3.84 (3H, s), and 3.34 (2H, br. s), 2.59 (3H, s). m/e (CI + ) 166 (MH + ). (iii) l-[2-Methoxy-5-(lH-tetrazoi-l-yl)phenyl1ethanone Triethyl orthoformate (28.79ml, 25.65g, 173mmol) was added to a stirred, heated (80°C) solution of l-(5-amino-2-methoxyphenyl)ethanone (8.16g, 49mmol) in acetic acid (80ml) and the mixture was stirred at 75°C for 1 hour. Sodium azide (9.64g, 148mmol) was added m portions over 90 minutes, then the mixture was stirred at 75°C for 4 hours. The mixture was cooled to room temperature and the solvent was evaporated under reduced pressure. Hydrochloric acid (1M, 100ml) was added and the mixture was stirred at room temperature 1 hour. The solid was collected. flushed with toluene (100ml) and dried in vacuo at room temperature. The residue was recrystallized from ethanol (700ml) to give l-[2-methoxv-5- (lH-tetrazol-l-yl)phenyl]ethanone as tan coloured needles (7.88g. 73%), Η NMR (dβ-DMSO) δ 10.06 (1H, s), 8.06 (2H, m), 7.46 (1H, d, J=7.8Hz), 3.99 (3H, s). and 2.60 (3H, s). m/e (CD) 219 (MH + ) (ιv) (±)-2.3-cιs-iV-{l-[2-Methoxy-5-(lH-tetrazol-l-yl)phenyllethyl}-2- phenylpιperιdm-3-amιne Titanium tetrachloπde (1.0M solution in dichlorome thane, 0.3ml, 0.3mmol) was added dropwise to a stirred, cooled (0°C) mixture of (2R3R, 2S3S)-cιs-2-phenylpιperιdιn-3-amιne (106mg, 0.6mmol), l-[2-methoxy-5- (lH-tetrazol-l-yl)phenyl]ethanone (131mg, O.βmmol) and tnethylamme (0.25ml, 182mg, 1.8mmol) in dichloromethane (10ml). The mixture was stirred at room temperature for 1 hour, cooled m ice and sodium cyanoborohydnde (113mg, l.δmmol) in methanol (2ml) was added The mixture was stirred at room temperature for 30 minutes, then hydrochloric acid (1M, 5ml) was added The mixture was stirred at room temperature for 1 hour, ethyl acetate (40ml) was added and the mixture was extracted with hydrochloric acid (1M, 3 x 20ml). The combined aqueous fractions were washed with ethyl acetate (2 x 20ml), adjusted to pΗ 9.0 with saturated aqueous potassium carbonate and extracted with ethyl acetate (3 x 20ml). The combined organic fractions were washed with saturated sodium hydrogen carbonate (20ml), dried (MgSO4) and evaporated under reduced pressure to give crude (±)-2,3-cιs-iV- . l-[2- methoxy-5-(lH-tetrazol-l-yl)phenyl]ethyl}-2-phenylpιperιdm-3-amme as a colourless foam (134mg) (v) (±)-2.3-cts--V-{ l-r2-Methoxy-5-(lH-tetrazol-l-yl)phenyllethylM-/gr/- butoxycarbonyl-2-phenylpιperιdιn-3-amme Di- rt-butyldicarbonate (218mg, lmmol) in dichloromethane (2ml) was added to a stirred, cooled (0°C) solution of crude (±)-2,3-cιs-Λ 7 -{l-[2- methoxy-5-(lH-tetrazol-l-yl)phenyl]ethyl}-2-phenylpιperιdm-3-amme (319mg) in dichloromethane (5ml) and the mixture was stirred at room temperature for 16 hours Saturated aqueous sodium hvdrogen carbonate (20ml) and water (10ml) were added and the mixture was extracted with dichloromethane (3 x 20ml) The combined organic fractions were dried (M S0 ) and evaporated under reduced pressure The residue was purified by flash column chromatography on silica gel, eluting with ethyl acetate/hexane (40:60 increasing to 70:30) to give (±)-2,3-cιs-Λ 7 -{l-[2- methoxy-5-(lH-tetrazol-l-yl)phenyl]ethyl}l-tert-butoxycarbonyl-2- phenylpiperidin-3-amine as a colourless foam (206mg, 29% from [2R3R, 2S3S]-αs-2-pheny_piperidin-3-amme), H NMR (CDC1 ) δ 9.00, 8.67 (total 1H, each s), 7.77-6.94 (8H, m), 5.47, 5.16 (total 1H, each br. m), 4.39 (1H, m), 3.93, 3.85 (total 3H, each s), 3.90 (1H, m), 3.04-2.80 (2H, m), and 1.84- 1.16 (17H, m). (vi) (±)-2.3-cis-iV-{l-[2-Methoxy-5-(lH-tetrazol-l-yl)phenyllethyl}-2- phenvIpiperidin-3-amine dihydrochloride Ethanolic hydrogen chloride (5M, 4ml) was added to a stirred, cooled (0°C) solution of (±)-2,3-cis-Λ r -{l-[2-methoxy-5-(lH-tetrazol-l-yl)phenyl]ethyl}-l- tert-butoxycarbony_-2-phenylpiperidin-3-am ine (206mg, 0.43mmol) in ethanol (2ml) and the mixture was stirred at room temperature for 90 minutes. The solid was collected and dried in vacuo at 60°C to give (±)-2.3- cis-Λ-{l-[2-methoxy-5-(lH-tetrazol-l-yl)phenyl]ethyl}(2-phenylpiperιdin-3- yl)amme dihydrochloride as a colourless solid (176mg, 90%), mp 241- 243°C. Η NMR (de-DMSO) δ 10.60-9.45 (4Η, m), 7.92-7.15 (8H. m). 4.77. 4.12 (total 1H, each br. s), 3.74, 3.59 (total 3H, each s). 3.71-3.10 (5H. m i. and 2.38-1.34 (7H, m). m/e (CI) 379 (MH + ). Analysis: C 2 I H2GNGO.2HC1.0.3H 2 O requires: C, 55.22: H, 6.18: N. 18.07: Found: C, 55.22; H, 6.31: N. 18.40%. HPLC analysis (210nm) showed this to consist of a 66:34 mixture of diastereoisomers. EXAMPLE 2 (±)-2 3-cts-Methyl 2-[(2-phenvipiperιdm-3-yl)amιno]-2-f2-methoχy-5-(lH- tetrazol-l-yl)phenvHethanoate dihydrochloride (l) 2-[2-Methoxy-5-(lH-tetrazol-l-yl ) phenvπ-2-oxoethanoιc acid Selenium dioxide (2.50g, 22.5mmol) was added to a suspension of l-[2- methoxy-5-(lH-tetrazol-l-yl)phenyl]ethanone (3.27g, lδmmol; from step (m) of Example 1) in pyndine (25ml) and the mixture was stirred at 100°C for 3 hours. The mixture was filtered, cooled and the solvent was evaporated under reduced pressure. Water (50ml) and methanol (10ml) were added and the pΗ was adjusted to 2 0 with hydrochloric acid (cone.) The mixture was extracted with ethyl acetate (4 x 50ml) and the combined organic fractions were washed with hydrochloric acid (2M, 50ml) and brine (50ml) dried (MgSO 4 ) and evaporated under reduced pressure to give 2- [2- methoxy-5-(lH-tetrazol-l-yl)phenyl]-2-oxoethanoιc acid as an orange solid (2.11g, 57%), Η NMR (de-DMSO) δ 10.10 (1Η, s), 8.22 (2Η, m), 7 54 (1H, d, J=9.6Hz), and 3 96 (3H, s). The aqueous layers were combined, treated with hydrochloric acid (cone , 20ml) and extracted with ethyl acetate (5 x 20ml) The combined organic fractions were dried (MgSθ4) and evaporated under reduced pressure to give additional 2-[2-methoxy-5-(lH-tetrazol- l-yl)phenyl]-2-oxoethanoιc li) Methyl 2-[2-methoxy-5-(lH-tetrazol-l-yl)phenyl]-2-oxoethanoate Methyl iodide (1 87ml, 4.26g, 30mmol) was added to a mixture of sodium hvdrogen carbonate (2.52g, 30mmol), and 2-[2-methoxv-5-(lH-tetrazol-l- vl)phenyl]-2-oxoethanoιc acid (3 37g, 13 6mmol) in dimethylformamide (120ml) and the mixture was stirred at room temperature for 6 hours The solvent was evaporated under reduced pressure, saturated aqueous sodium hvdrogen carbonate (100ml) and water (50ml) were added and mixture was extracted with ethyl acetate (4 x 100ml) The combined organic fractions were washed with saturated aqueous sodium hydrogen carbonate (4 x 100ml), dried (MgSO4) and evaporated under reduced pressure to give methyl 2-[2-methoxy-5-(lH-tetrazol-l-yl)phenyl]-2- oxoethanoate as an orange solid (3.36g, 94%), Η NMR (CDCls) δ 9.02 (1Η, s), 8 11 (1Η, d, J=2.8Ηz), 8.03 (IH, dd, J=9.0, 2.8Hz), 7.23 (IH, d, J=9 0Hz), 3.99 (3H, s), and 3.96 (3H, s). (111) (±)-2,3-cz-i-Methyl 2-[(l-tβrt-butoxycarbonyl-2-phenylpiperιdm-3- yl)ammo1-2-[2-methoxy-5-(lH-tetrazol-l-yl)phenyllethanoate Citric acid (1.15g, 6mmol) was added to a mixture of (2R3R, 2S3S)-cιs-2- phenylpιperιdm-3-amιne (528mg, 3mmol), methyl 2-[2-methoxy-5-(lH- tetrazol-l-yl)phenyl]-2-oxoethanoate (786mg, 3mmol) and powdered, activated 3A molecular sieves (1 5g) in methanol (25ml) and the mixture was stirred at room temperature for 18 hours. Sodium cyanoborohydnde (188mg, 3mmol) was added and the mixture was stirred at room temperature for 6 hours. Further sodium cyanoborohydnde (188mg, 3mmol) was added and the mixture was stirred at room temperature for 24 hours The mixture was filtered through Celite™, washing with methanol and dichloromethane, and the solvent was evaporated under reduced pressure. Ethyl acetate (50ml) was added and the mixture was extracted with hydrochloric acid (1M, 3 x 50ml). The combined aqueous fractions were washed with ethyl acetate (2 x 50ml), adjusted to pH 10.0 with saturated aqueous potassium carbonate and extracted with dichloromethane (3 x 50ml) The combined organic fractions were dried (MgSO ) and evaporated under reduced pressure The residue was dissolved in dichloromethane (5ml), cooled m ice and d\-tert- butyldicarbonate (357mg, 1 6mmol) in dichloromethane (5ml) was added The mixture was stirred at room temperature for 22 hours, saturated aqueous sodium hydrogen carbonate (20ml) and water (10ml) were added and the mixture was extracted with dichloromethane (3 x 20ml) The combined organic fractions were dried (MgSO i) and evaporated under reduced pressure. The residue was purified by flash column chromatography on silica gel, eluting with ethyl acetate/hexane (50:50 increasing to 70:30) to give (±)-2,3-cis-methyl 2-[(l-teri-butoxycarbonyl-2- phenylpiperidin-3-yl)amino]-2-[2-methoxy-5-(lH-tetrazol-l-yl)phenyl]- ethanoate as a colourless foam (415mg, 26%), Η NMR (CDC1 3 ) δ 8.77 (1Η. s). 7.74-6.94 (8Η, m), 5.29 (IH, br. s), 4.92 (IH, s), 3.88 (IH, m), 3.81 (3H, s), 3.69 (3H, s), 3.11 (IH, m), 2.80 (2H, m), 1.96-1.53 (4H, m), and 1.39 (9H, s). m/e (CI + ) 523 (MH + ). (IV) (±)-2,3-cιs-MethvI 2-f(2-phenylpiperidin-3-yl)aminol-2-[2-methoxy-5- (lH-tetrazol- l-vDphenyllethanoate dihydrochloride Methanolic hydrogen chloride (4M, 4ml) was added to a stirred, cooled (0°C) solution of (±)-2,3-cis-methyl 2-[(l-tert-butoxycarbonyl-2- phenylpiperidin-3-yl)amino]-2-[2-methoxy-5-(lH-tetrazol-l- yl)p he nyl] ethanoate (339mg, 0.65mmol) in methanol (2ml) and the mixture was stirred at room temperature for 90 minutes. The solvent was evaporated under reduced pressure and the residue was triturated with ethanol (5ml). The solid was collected and dried in vacuo at 60°C to give (±)-2.3-cis-methyl 2-[(2-phenylpipehdin-3-yl)amino]-2-[2-methoxy-5-(lH- tetrazol-l-yl)phenyl]ethanoate dihydrochloride as a colourless solid (239mg, 74%), mp 197-199°C, Η NMR (de-DMSO) δ 10.07 (IH, s), 9.54 (IH, br. s), 9.12 (IH, br. s), 7.74 (IH, dd, J=8.9, 2.7Hz), 7.62 (IH, d. J=2.7Hz), 7.34-7.20 (5H, m), 7.12 (IH, d, J=8.9Hz), 4.45 (IH, br. s), 4.17 (IH, s), 3.65 (IH, br. s), 3.57 (3H, s), 3.55 (3H, s), 3.32 (2H, m), 3.00 (2H, m), 2.06 (2H, m), 1.85 (IH, m), and 1.65 (IH, m). m/e (CI + ) 423 (MH + ). Analysis: C22H 2 CNGO3.2HC1.0.5H 2 O requires: C, 52.39; H. 5.79: N. 16.66; Found: C, 52.21; H. 5.70; N. 16.32%. HPLC analysis (210nm) showed this to consist of an 85: 15 mixture of diastereoisomers. EXAMPLE 3 (±)-2.3-cιs-2-[(2-Phenylpiperidin-3-yl)ammo]-2- 2-methoxy-5-(lH-tetrazol- l-yl)phenyllethanol dihydrochloride (i) (±)-2,3-cis-2-[ ( l-tert-Butoxycarbonyl-2-phenylpiperidin-3-yl)amino]- 2-r2-methoxy-5-(lH-tetrazol-l-yl)phenyl1ethanol Lithium aluminium hydride (0.5M in dimethoxyethane, 3.06ml, 1.53mmol) was added dropwise to a stirred, cooled (-40°C) solution of (±)-2,3-cts- methyl 2-[(l-tert-butoxycarbonyl-2-phenylpiperidin-3-yl)amino]-2-[2- methoxy-5-(lH-tetrazol-l-yl)phenyl]ethanoate (570mg, 1.09mmol; from step (iii) of Example 2) in tetrahydrofuran (15ml) and the mixture was stirred at (-30°C) for 30 minutes. Methanol (5ml) was added and the mixture was allowed to warm to room temperature. Saturated aqueous sodium hydrogen carbonate (40ml) and water (20ml) were added and mixture was extracted with dichloromethane (3 x 40ml). The combined organic fractions were dried (MgSO 4 ) and evaporated under reduced pressure. The residue was purified by medium pressure liquid chromatography on silica gel, eluting with ethyl acetate/hexane (70:30 increasing to 100:0). The residue was recrystallized from ethyl acetate/hexane (50:50, 15ml) to give (±)-2,3-cis-2-[(l-tert-butoxycarbonyl-2- phenylpιperidιn-3-yl)amιno]-2-[2-methoxy-5-(lH-tetrazol-l- yl)phenyl]ethanol as a colourless solid (282mg, 52%), Η NMR (CDC1 3 ) δ 8.86 (1Η, br.s), 7.60 (2Η, m), 7.40 (2H, m), 7.22 (3H, m), 6.95 (IH, d, J=8.9Hz), 5.18 (IH. br.m), 4.35 (IH, br.m), 3.87 (2H, m), 3.81 (3H. s), 3.67 (IH. m), 3.43 (IH, m), 3.00 (IH. m), 2.85 (IH, m), 2.13 (IH, br.s), 1.96 (2H, m), 1.79 (IH, m), 1.60 (IH, m), and 1.32 (9H, s). m/e (CD) 495 (MH ). (n) (+)-2.3-cts-2-[(2-Phenylpiper din-3-yl)ammol-2-[2-methoxy-5-(lH- tetrazol-l-yl)phenyl]ethanol dihydrochloride Ethanolic hydrogen chloride (5M, 4ml) was added to a stirred, cooled (0°C) suspension of (±)-2,3-αs-2-[(l-ter(-butoxycarbonyl-2-phenylpιpeπdm-3- yl)ammo]-2-[2-methoxy-5-(lH-tetrazol-l-yl)phenyl]ethanol (267mg, 0.54mmol) in ethanol (2ml) and the mixture was stirred at room temperature for 90 minutes. The solvent was evaporated under reduced pressure and the residue was triturated with ethanol (5ml). The solid was collected and dried in vacuo at room temperature to give (±)-2,3-cιs-2-[(2- phenylpiperidm-3-yl)amino]-2-[2-methoxy-5-(lH-tetrazol-l- yl)phenyl]ethanol dihydrochloride as a colorless solid (233mg, 92%), mp 238-240°C, ] Η NMR (de-DMSO) δ 10.01 (1Η, s), 9.86 (1Η, br.s), 7.70 (1Η. m), 7.58-7.20 (6Η, m), 7.12 (IH, d, J=9.0Hz), 4.73 (IH, br.s), 4.00-3.06 (10H, m), 3.60 (3H, s), 2.29 (2H, m), 1.94 (IH, m), and 1.78 (IH, m). m/e (CD) 395 (MH + ). HPLC analysis (210nm) showed this to consist of a 93:7 mixture of diastereoisomers.

Claims: CLAIMS: 1. A compound of formula (I): R° (I) wherein R 1 represents a 5- or 6-membered aromatic heterocyclic group containing 1, 2, 3 or 4 heteroatoms selected from nitrogen, oxygen and sulphur, which is optionally substituted by one or two substituents. selected from Cι- alkyl. Cs-Tcycloalkyl, C3 -7cycloalkylCι- _alkyl, SR X , SOR , SO2R*, phenyl, NR a R\ NR a COR x , CHaCOCFs and CF. . where R a and R b are independently hydrogen or Cι. 4 alkyl and R x is C 1-4 alkyl; R 2 represents halogen, Ci-βalkyl, Ci-ealkoxy, CF 3 , OCFs, NOc, CN, SR". SOR a , SO2R a , CO-R 8 , CONR a R b , Ca-βalkenyl, Ca-βalkynyl or Cι. 4 alkyl substituted by Ci 4alkoxy, where R a and R b each independently represen hydrogen or C 1.4 alkyl; R 3 represents hydrogen or Ci ealkyl; R 4 represents hydi-ogen, halogen, Ci-βalkyl, Ci βalkoxy, hydi'oxy, CFs. NO2, CN. SR a , SOR a , S0 2 R a , C0 2 R a , CONR a R b , Cu-βalkenyl, C2 ealkynyl or Cι- 4 alkyl substituted by Cι- 4 alkoxy, where R a and R each independently represent hydrogen or Cι- 4 alkyl; R 5 represents hydrogen, halogen Ci ealkyl, Ci βalkoxy substituted by Ci 4alkoxy or CF3, R 6 represents hydrogen or Ci ealkyl, R 6 represents Ci ealkyl optionally substituted by a hydroxy group or the group -CO2R c , where R c represents Ci ealkyl, R 9 represents halogen, Ci ealkyl, oxo, COaR 3 or CONR a R b , m is zero or 1, p is zero, 1 or 2, and q is zero, 1 or 2, or a pharmaceutically acceptable salt or prodrug thereof 2. A compound as claimed in claim 1 wherein R 1 is a group selected from pyrrole, furan, thiene, pyndine, pyrazole imidazole oxazole, isoxazole, thiazole, isothiazole, pyrazine, pynmidme, pyndaz e, tnazole, oxadiazole, thiadiazole, tnazine, and tetrazole, each of which heteroarvl groups being optionally substituted as defined in claim 1 3 A compound as claimed in claim 1 or claim 2 wherein R 1 is a 5-membered aromatic heterocyclic group selected from where R !0 is hydrogen, Ci .alkyl C . τcycloalkyl Cs -cycloalkyl ealkyl SR X SOR Sθ x , phenyl, NR a R b , NR a COR x CIUCO CF. or CFs where R a and R b are independently hydrogen or Ci 4alkyl and R is Ci 4alkyl 4 A compound as claimed in claim 3 wherein R 1 is the group wherein R 10 is as defined in claim 3. 5. A compound as claimed in any of claims 1 to 4 wherein R 2 ιs Cι 4 alkyl, Cι 4 alkoxy, halogen, CF3 or OCFs. 6. A compound as claimed in any of claims 1 to 5 wherein R 2 is in the meta- or para-position with respect to the group R : -(CH2) m -. 7. A compound as claimed in any of claims 1 to 6 wherein R 3 is hydrogen or Ci 4 alkyl. 8. A compound as claimed in any of claims 1 to 7 wherem R 4 is hydrogen and R 5 is hydrogen or 4-fluoro. 9 A compound as claimed 111 any of claims 1 to 8 wherein R Ca is hydrogen, methyl and ethyl. 10 A compound as claimed in any one of claims 1 to 9 wherem R 6b is Ci 4 alkyl optionally substituted by a hydroxy group, or the group -Cθ2R c where R c is Ci 4 alkyl. 11 A compound as claimed in claim 1 formula (la) (la) wherein R 1 , R 2 , R 3 , R 6b and p are as defined in claim 1 : and A 1 is fluorine or hydrogen; or a pharmaceutically acceptable salt or prodrug thereof. 12. A compound selected from: (±)-2,3-cι ' s-A 7 -{l-[2-methoxy-5-(lH-tetrazol- l-yl)phenyl]ethyl}-2- phenylpipendin-3-amine; (±)-2,3-cis-2-[(2-phenylpipendin-3-yl)amino]-2-[2-methoxy-5-(lH-tetrazol- l-yl)phenyl]ethanol; or a pharmaceutically acceptable salt or prodru thereof. 13. A compound as claimed in any preceding claim for use in therapy. 14. A pharmaceutical composition compiismg a compound as claimed in any one of claims 1 to 12 in association with a pharmaceutically acceptable carrier or excipient. 15. A method for the treatment or prevention of physiological disorders associated with an excess of tachykinins, which method compnses administration to a patient in need thereof of a tachykinm reducing amount of a compound according to claim 1 16 A method according to claim 15 for the treatment or prevention of pam or inflammation. 17 A method according to claim 15 for the treatment or prevention of migraine. 18. A method according to claim 15 for the treatment or prevention of emesis 19 A method according to claim 15 for the treatment or prevention of postherpetic neuralgia. 20 The use of a compound as claimed in any one of claims 1 to 12 for the manufacture of a medicament for the treatment or prevention of a physiological disorder associated w th an excess of tachykinins 21 The use of a compound as claimed in any one of claims 1 to 12 for the manufacture of a medicament for the treatment or prevention of pam or inflammation 22 The use of a compound as claimed in any one of claims 1 to 12 for the manufacture of a medicament for the treatment or prevention of migraine 23 The use of a compound as claimed in any one of claims 1 to 12 for the manufacture of a medicament for the treatment or prevention of emesis 24 The use of a compound as claimed in any one of claims 1 to 12 for the manufacture of a medicament for the treatment or prevention of postherpetic neuralgia 25 A process for the preparation of a compound as claimed in Claim 1 which compnses (A) reacting a compound of formula (II) with a compound of formula (IH). (ID (HI) wherein R 1 , R 2 , R 4 , R 5 , R 6a , R 6b , R 9 m, n, p and q are as defined in claim 1, except that any reactive moiety is protected by a suitable protecting group, and one of R 30 and R 31 represents a leaving group and the other of R 30 and R 31 represents NHR 3 , where R 3 is as defined in claim 1 in the presence of a base, followed by deprotection, if required or (B), where R 6a is hydrogen reductive animation of a compound of formula (II) m which R 30 is the group NHR 3 w th a compound of formula (IV) (TV) m the presence of a reducing agent; or (C), where m is zero and R 1 is a tetrazol- 1-yl group substituted by a 5-amino moiety, reaction of intermediates of formula (V): (V) with ammonium chloiide and sodium azide at elevated temperature; or (D), a couphng reaction between a compound of formula (VI) and (ATI): R° (VI) (VI 1) wherein one of R 40 and R 41 is B(OH)2 or Sn(alkyl)3 or a denvative thereof and the other is a leaving group; or (E), reduction of a compound of formula (VIII): R 1 with the proviso that R 9 is not oxo: each process being followed, where necessaiy. by the removal of any protecting group where present; and when the compound of formula (I) is obtained as a mixture of enantiomers or diastereoisomers, optionally resolving the mixture to obtain the desired enantiomer, and/or. if desired, converting the resulting compound of formula (I) or a salt thereof, into a pharmaceutically acceptable salt or prodrug thereof.

Inventors: BAKER RAYMOND, ELLIOTT JASON, SWAIN CHRISTOPHER JOHN, BAKER, RAYMOND, ELLIOTT, JASON, SWAIN, CHRISTOPHER, JOHN
Applicants: BAKER RAYMOND, ELLIOTT JASON, MERCK SHARP & DOHME, SWAIN CHRISTOPHER JOHN, BAKER, RAYMOND, ELLIOTT, JASON, MERCK SHARP & DOHME LIMITED, SWAIN, CHRISTOPHER, JOHN
Application year: 1996
Main classification: C07D401
IPC codes: A61K31, A61P1, A61P9, A61P11, A61P17, A61P25, A61P29, A61P35, A61P43, C07D401, C07D403