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In people who are deficient in CYP2D6, coadministration of modafinil with substrates of CYP2D6 that have ancillary routes of elimination as a result of CYP2C19 (eg, tricyclic antidepressants and selective serotonin reuptake inhibitors) could lead to elevated circulating levels of these medicines and require dose adjustment (Robertson et al 2000; PR