Thanks for asking, I'd forgotten that I didn't do an update after her appointment.
medication adjustment is going on, titrating her up to 300mg trileptal twice a day and the Kapvay has been doubled. So far so good, I've seen improvements already and she's only taking 225 of the trileptal twice a day right now (up from the 150 2x/day). Of course it's only been a few days, and I might have just jinxed it all.