My autistic 11 year old has been taking Trileptol 10 ml 3 times per day for about a year. We still experience breakthrough seizures, especially during her cycle. So, her neurologist is starting her on Trokendi xr titration beginning tomorrow at bedtime. Each dose for 1 week 50 mg, 100 mg, 150 mg, 200 mg while still taking the trileptal until we get to the therapeutic dosage of Trokendi xr. I am concerned about all of the possible side effects, but very hopeful that it will help control her appetite as she has gained 30 lbs since February, since starting the Depo shot to control her cycle and her hormones. Does this loss of appetite occur immediately when beginning Trokendi xr or evolve as the dosage is raised?