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Despite the fact that only the cyp3a4 liver enzyme was initially thought to be involved in trazodone s metabolism, later research has discovered it s active metabolite, mcpp is metabolized by cyp2d6, which explains the myriad of paradoxical symptoms experienced by poor 2d6 metabolizers and people who are prescribed 2d6 inhibitors antidepressants, adhd medications, otc sleep aides in combination with trazodone.