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In individuals who are deficient in CYP2D6, coadministration of modafinil with substrates of CYP2D6 that have ancillary routes of elimination via CYP2C19 (eg, tricyclic antidepressants and selective serotonin reuptake inhibitors) may bring about elevated circulating levels of these medications and require dose adjustment (Robertson et al 2000; PROV