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Lousy/Substantial Metabolizers, CYP2D6 The development in the active metabolite, M1, is mediated by CYP2D6, a polymorphic enzyme. Close to 7% from the population has minimized activity on the CYP2D6 isoenzyme of cytochrome P450 metabolizing enzyme process. These folks are “inadequate metabolizers” of debrisoquine, dextromethorphan and tricyclic