This is a common method where an amine and a ketone or aldehyde are reacted in the presence of a reducing agent. The amine serves as the 1-position substituent, and the ketone/aldehyde provides the 4-position substituent.
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(2S,3S,11bR)-8-benzyloxy-3-ethyl-1,3,4,6,7,11b-hexahydro-9,10-dimethoxy-2H-benzoquinolizine-2-ethanol