NK1 antagonists

A method of treating a physiological disorder, symptom or disease, selected from cough, emesis, nausea and vomiting, comprising:

• administering to a patient in need thereof an effective amount of at least one compound of formula I:
• or a pharmaceutically acceptable salt thereof,
• wherein:
• R1 and-R2 are selected from the group consisting of alkyl, haloalkyl, alkyl substituted with one or more hydroxyl groups, —CN alkynyl, —N(R6)2, —N(R6)—S(O2)-alkyl, —N(R6)—C(O)—N(R9)2, -alkylene-CN, -cycloalkylene-CN, -alkylene-O-alkyl, —C(O)-alkyl, —C(═N—OR5)-alkyl, —C(O)—O-alkyl, -alkylene-C(O)-alkyl, -alkylene-C(O)—O-alkyl, -alkylene-C(O)—N(R9)2,
• with the proviso that at least one of R1 and R2 is —CN,
• W is ═C(R8)— or ═N—;
• X is —C(O)— or —S(O2)—;
• Y is selected from the group consisting of —CH2—, —O—, and —N(R6)—C(O)—, with the proviso that:
• (a) The nitrogen atom of —N(R6)—C(O)— is bonded to X, and
• (b) if R1 and/or R2 is
• and Y is —O—, X is not —S(O2)—;
• Z is —C(R7)2, —N(R6)—, or —O—;
• R3 is selected from the group consisting of H, and unsubstituted alkyl;
• R4 is H;
• R5 is H or alkyl;
• R6 is selected from the group consisting of H, alkyl, cycloalkyl, and aryl;
• each R7 is independently H or alkyl;
• or
• each R7, together with the ring carbon to which they are shown attached, form a cycloalkylene ring;
• R8 is selected from the group consisting of H, alkyl, alkyl substituted with one or more hydroxyl groups, —N(R6)2, —N(R6)—S(O2)-alkyl, —N(R6)—S(O2)-aryl, —N(R6)—C(O)-alkyl, —N(R6)—C(O)-aryl, alkylene-O-alkyl, and —CN;
• R9 is selected from the group consisting of H, alkyl, and aryl, or each R9, together with the nitrogen to which they are shown attached, form a heterocycloalkyl ring;
• Ar1 is unsubstituted phenyl;
• Ar2 is phenyl substituted with 0-3 substituents selected from the group consisting of haloalkyl;
• n is 0, 1, or 2;
• and
• m is 1, 2 or 3.