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Hunger and fullness cues feel more reliable Meals feel routine instead of reactive Energy feels more consistent day to day Food choices feel less emotionally charged This is often when eating shifts from effort to habit

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5.10 Hyperammonemia and Encephalopathy Associated with Concomitant Topiramate Use Concomitant administration of topiramate and valproate has been associated with hyperammonemia with or without encephalopathy in patients who have tolerated either drug alone