The role of CYP2D6 in the brain may be significant when the classical route of serotonin synthesis governed by tryptophan hydroxylase 2 (TPH2) is impaired [ 50 , 51 ] and/or when the CYP2D gene is duplicated or amplified ( CYP2D6*2 gene variant) or when CYP2D activity is modified by such inducers as alcohol or nicotine [ 43 , 52 , 53 , 54 , 55 ] or by psychotropic drugs, such as antidepressants [ 56 , 57 , 58 , 59 , 60 ] or neuroleptics [ 56 , 61 , 62 , 63 , 64 ].
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