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Mirtazapine is often chosen to treat depression in patients on warfarin due to its minimal interaction with the anticoagulant. It functions as an atypical antidepressant, and one of its significant advantages is that it does not significantly affect the metabolism of warfarin. This is a crucial consideration in patients undergoing anticoagulation therapy, as many commonly used antidepressants can interact with warfarin, potentially increasing the risk of bleeding by affecting the INR (International Normalized Ratio) levels.

The other medications listed, including fluoxetine, citalopram, and sertraline, are often carefully monitored when prescribed to patients on warfarin. These SSRIs (selective serotonin reuptake inhibitors) can influence warfarin's effects through various mechanisms, including inhibition of liver enzymes that metabolize warfarin. This makes mirtazapine the preferred option for managing depression in individuals already on warfarin therapy, as it minimizes potential drug-drug interactions and simplifies the management of their overall treatment plan.