Breakthrough Siezures while taking Trileptal

A brief seizure history. I started having seizures in 2005. I then had one 4 months later. A neurologist prescribed depakote which was not effective. I had about 4 grand mal and numerous petit mal siezures over the next 1.5 years until i was prescribed trileptal at 1800 mg per day.
I had no more siezures until 1/2/2022. I had one then likely due to missing medication. Then i had one again this morning. I have an appointment to see my neurologist on 10/23/24.
One other note. Before 2018 i was taking (3) 1 mg tabs per day ativan.
In 2018, my new pcp got me off the ativan and got me onto 15 mg lexapro per day.
I have some questions.
Does trileptal become inaffective over time?
My weight has went from 160 to 190 in the last 8 years, should my prescription go up with that?
Is there a replacement for trileptal?
Can dose be raised from 1800 mg per day for a 190 lb. male?
Does prescription lose effectiveness over time?
Is there a good companion prescription to trileptal?