Metabolism: This product or service is often a metabolite of tramadol. Tramadol is metabolized in the liver via the enzyme CYP2D6 to form O-DSMT. This metabolite has an extended half-existence than tramadol, resulting in prolonged results.Flipping the way with the R2 and R1 bonds results in the R- and S- enantiomers of O-Desmethyltramadol. O-DMST i