ClinicalTrials.gg
Not yet recruitingNCT06924827CANN-SWITCHUpdated Sep 11, 2026

A Study to Investigate the Transition of Children From 'Artisanal" Cannabidiol (CBD) to Epidiolex

A Phase 4 interventional study of Epidiolex 100 mg/mL Oral Solution in Dravet Syndrome (DS) and Lennox-Gastaut Syndrome (LGS), sponsored by Elizabeth Donner. Not yet recruiting at 1 site in Canada. Open to participants aged 2 Years to 18 Years. Per ClinicalTrials.gov, last updated 2026-09-11.

Sponsored by Elizabeth Donner · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
25
Allocation
Not applicable
Ages
2 Years to 18 Years
Sex
All
01

Study summary

The goal of this clinical trial is to learn the best way to switch children with Lennox-Gastaut Syndrome (LGS) or Dravet Syndrome (DS) taking 'artisanal' (non pharmaceutical-grade) cannabidiol (CBD) to Epidiolex for treatment of seizures. The main questions it aims to answer are:

  • How well does a gradual switch from 'artisanal' CBD to Epidiolex work?
  • Does the same dose of Epidiolex as 'artisanal' CBD work best?
  • What side-effects or medical problems do participants have when switching from 'artisanal' CBD to Epidiolex?

Researchers will examine how successful switching from 'artisanal' CBD to Epidiolex is.

Participants will:

  • Gradually increase their dose of Epidiolex and reduce their dose of 'artisanal' CBD until they are taking just Epidiolex
  • Visit the clinic five times over 20 weeks for checkups and tests
  • Keep a diary of their seizures, symptoms and the number of times they use a rescue seizure medication
02

Conditions studied

  • Dravet Syndrome (DS)
  • Lennox-Gastaut Syndrome (LGS)

Keywords

  • Cannabidiol (CBD)
  • Epidiolex
  • Seizures
  • Epilepsy
  • Lennox-Gastaut Syndrome (LGS)
  • Dravet Syndrome (DS)
03

In context

Epilepsies, Myoclonic

92 studies on the registry are indexed under Epilepsies, Myoclonic; 21 are open to participants now.

This study's planned enrollment of 25 is below the median of 31 across 56 interventional studies indexed under Epilepsies, Myoclonic.

Browse Epilepsies, Myoclonic studies →

Lead sponsor

This is the only study on the registry with Elizabeth Donner as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Male or female aged 2 through 18 years, inclusive.
  • Clinical diagnosis of Dravet or Lennox Gastaut Syndrome:

Clinical diagnosis of Dravet Syndrome supported by:

  1. Onset of seizures within the first year of life.
  2. Initial seizures present as fever-induced or fever-triggered seizures, hemi-clonic, generalized tonic-clonic, prolonged seizures (more than 15 minutes).
  3. Emergence of other seizure types after 1 year of age.
  4. Normal development within the first year of age, then emergence of neurodevelopmental difficulties or delay.

Clinical diagnosis of Lennox Gastaut Syndrome supported by:

a. History of an EEG with slow/disorganized background and slow (\<2.5 Hz or less) spike and wave activity or generalized paroxysmal fast activity (GPFA).

b. History of more than 1 type of generalized seizures, including drop seizures (tonic, atonic or tonic-clonic).

  • Participant must be willing and able to give written for participation. If the participant is not qualified or unable to provide written consent based on age, development, intellectual capacity or other factors, the parent or legally authorized representative must provide written informed consent on their behalf.
  • Must be on a stable dose of a licensed artisanal cannabidiol (CBD) product as maintenance therapy for seizure control for a minimum of 3 months prior to screening (visit 1).
  • 'Artisanal' CBD dose must be between 5 mg/kg/day and 20mg/kg/day.
  • 'Artisanal' CBD preparation must be a high CBD to THC formulation defined as a minimum CBD:THC ratio of 20:1.
  • Must be taking a minimum of 1 other anti-seizure medication (ASM) in addition to an 'artisanal' form of CBD.
  • Must be on a stable dose of ASMs for a minimum of 28 days prior to screening (visit 1) and remain on a stable dose throughout the entire study unless medically necessary change(s) are required for safety events.
  • Participants with a vagal nerve stimulator (VNS) must have the following conditions met:

    1. The VNS has been in place for a minimum of 3 months prior to screening (visit 1).
    2. The settings have remained constant for 28 days prior to screening (visit 1) and are expected to remain constant throughout the entire study.
    3. The battery is expected to last for the duration of the study.
  • Participants on the ketogenic diet must be on a stable regime for a minimum of 28 days prior to screening (visit 1) and expected to remain stable throughout the entire study.
  • Participant and/or caregiver must be willing to maintain a seizure diary throughout the duration of the study.

Exclusion criteria

Exclusion Criteria:

  • Previous or current exposure to Epidiolex.
  • Supplemental use of cannabinoid-containing products, including but not limited to:

    1. Recreational use of cannabis.
    2. Use of artisanal CBD as a seizure rescue medication.
    3. Use of more than one formulation of 'artisanal' CBD (e.g. THC supplementation).
  • Pregnant or breastfeeding.
  • Any , unstable medical condition other than epilepsy that, in the opinion of the investigator, could place the participant at increased risk or interfere with the results of the study.
  • Hepatic impairment at screening (visit 1) defined as either of the following conditions:

    1. or AST > 5x (ULN).
    2. ALT or AST > 3x ULN and total >2x ULN (or >1.5).
  • Known sensitivity to any ingredient in Epidiolex, including sesame and sesame oil.
  • Unwillingness to refrain from alcohol consumption throughout the duration of the study.
  • Unwillingness of females of to use a highly effective form of . Acceptable methods include: hormonal contraceptives, intra-uterine devices, bilateral tube occlusion, vasectomized partner and sexual abstinence.
  • Currently enrolled in another clinical trial.
  • Have suicidal plan/intent, active suicidal thoughts, or a suicide attempt in the past 6 month prior to screening.
Terms in these criteria, in plain language(8)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
25 participants (estimated)

Study arms

  • Experimental
    Epidiolex Treatment

    The participant's dose of Epidiolex will be matched to their dose of 'artisanal' cannabidiol (CBD). Epidiolex will be titrated over two weeks with a concomitant taper of the participant's 'artisanal' CBD. CBD doses during transition week 1 will consist of 75% 'artisanal' and 25% Epidiolex, followed by 50% 'artisanal' and 50% Epidiolex for transition week 2. Participants will commence a CBD dose comprised of 100% Epidiolex once reaching the maintenance period of the study. Participants will remain on their matched dose of Epidiolex throughout the maintenance period, unless a dose modification is clinically indicated for efficacy, safety or tolerability. The daily dose of Epidiolex should not exceed the maximum approved dose of 20 mg/kg/day.

    Drug: Epidiolex 100 mg/mL Oral Solution

Interventions

  • DrugEpidiolex 100 mg/mL Oral Solution

    Drug page: Cannabidiol

    The participant's 'artisanal' CBD and Epidiolex dose should be taken consistently with food or consistently without food throughout the entire study. The participant's dosing with or without food should be consistent with their method of dosing of 'artisanal' CBD prior to screening. Oral administration is recommended. When necessary, Epidiolex can be enterally administered via silicone feeding tubes, such as nasogastric or gastrostomy tubes.

06

What researchers measure

Primary outcomes

  1. The success rate of transition of children from 'artisanal' CBD to Epidiolex.

    Participants successfully transitioned from 'artisanal' CBD to Epidiolex if they complete the transition protocol and continue treatment with Epidiolex at visit 2 following the two-week transition phase of the study. The success rate will be determined as the percentage of participants that complete the two-week transition phase.

    Time frame: Baseline (visit 2, Day 1) through visit 4 (Day 15), the two-week transition phase.

Secondary outcomes

  1. The acceptability rate of Epidiolex in children previously treated with 'artisanal' CBD.

    Participants accepted transition to Epidiolex if they continued treatment with Epidiolex after the last scheduled visit of the maintenance period (visit 7). The acceptability rate will be determined as the percentage of participants that continue treatment with Epidiolex after the last scheduled visit of the maintenance period (visit 7, Day 85).

    Time frame: Baseline (visit 2, Day 15) to end of treatment (visit 7, Day 85).

  2. The change in seizure frequency following transition of children from 'artisanal' CBD to Epidiolex.

    The percent change (increase or decrease) from baseline in 28-day seizure frequency during the maintenance period. Seizure frequency will be calculated as the total number of seizures divided by the number of days with seizure data, multiplied by 28.

    Time frame: Baseline (visit 2, Day 1) through the end of treatment (visit 7, Day 85).

  3. Change in reported Pediatric Epilepsy Side-Effects Questionnaire (PESQ) score.

    The Pediatric Epilepsy Side Effects Questionnaire (PESQ) is a rating scale to assess pediatric participant-reported side effects associated with anti-seizure medication treatment. Each side-effect is rated on a 6-point Likert scale as follows: (1) - "Not present", (2) - "Low severity", (3) - "Low-moderate severity", (4) - "Moderate severity", (5) - "Moderate-high severity", (6) - "High severity". Higher scores indicated worse side-effects.

    Time frame: Baseline (visit 2, Day 1) through visit 4 (Day 15), visit 5 (Day 29) and end of treatment (visit 7, Day 85).

  4. Change Clinical Global Impression of Improvement (CGI-I) score.

    The Clinical Global Impression of Improvement (CGI-I) is a 7-point Likert scale used to rate the overall change in seizure control, behaviour, safety and tolerability after transitioning to Epidiolex relative to baseline. The participant's overall improvement is rated by the clinician and caregiver as: 1- "very much improved", 2- "much improved', 3- "minimally improved", 4- "no change", 5- "minimally worse", 6- "much worse", and 7- "very much worse". Higher scores indicate worse condition.

    Time frame: Baseline (visit 2, Day 1) through visit 5 (Day 29) and end of treatment (visit 7, Day 85).

  5. Change in Clinical Global Impression of Seizure Intensity/Duration (CGI-CSID) score.

    The Clinical Global Impression of Change in Seizure Intensity/Duration (CGI-CSID) is a 7-point Likert scale used to rate the overall change in seizure intensity and/or duration after transitioning to Epidiolex relative to baseline. The participant's overall improvement is rated by the clinician and caregiver as: 1- "very much improved", 2- "much improved', 3- "minimally improved", 4- "no change", 5- "minimally worse", 6- "much worse", and 7- "very much worse". Higher scores indicate worse condition.

    Time frame: Baseline (visit 2, Day 1) through visit 5 (Day 29) and end of treatment (visit 7, Day 85).

  6. Change in Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) score.

    The Quality of Life in Childhood Epilepsy Questionnaire (QOLCE-55) is a caregiver-reported questionnaire that evaluates quality of life in epileptic children. It contains 55 questions that measure quality of life in 4 areas: cognitive functioning, emotional functioning, social functioning, and physical functioning. Each question is rated on a 5-point Likert scale, with the option to answer "not applicable" as follows: (1) - "All of the time", (2) - "Most of the time", (3) - "Some of the time", (4) - "A little of the time", (5) - "None of the time", (6) - Not applicable. Higher scores indicate higher health-related quality of life.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  7. Change in Measure Yourself Medical Outcome Profile 2 (MYMOP2) score.

    The Measure Yourself Medical Outcome Profile 2 (MYMOP2) questionnaire is a scale that allows participants or caregivers to identify the problem(s) that are most important to them/the participant, and rate the severity of the problem (s) on a 7-point Likert scale ranging from 0 (as good as it can be) to 6 (as bad as it could be). Higher scores indicate worse problems.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85)

  8. Change in Children's Sleep Habit Questionnaire (CSHQ) score.

    The Children's Sleep Habit Questionnaire (CSHQ) is a caregiver-reported questionnaire to measure sleep behaviours in children. The questionnaire has 45 questions about bedtime resistance, sleep onset delay, sleep duration, sleep anxiety, night wakings, parasomnias, sleep disordered breathing, and daytime sleepiness. Each question is rated on a 3-point Likert scale as follows: (1) - "Usually (5 or more times in a week)", (2) - "Sometimes (2-4 times in a week)", (3) - Rarely (never or 1 time during a week). A higher score indicates more sleep problems.

    Time frame: Baseline (visit 2, Day 1) through visit 5 (Day 29) and end of treatment (visit 7, Day 85).

  9. Number of dose increases in anti-seizure medications (ASMs) after starting Epidiolex.

    The number of dose increases in anti-seizure medications (ASMs), including Epidiolex, due to worsening seizure burden or other factors.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  10. Number of dose decreases in anti-seizure medications (ASMs) after starting Epidiolex.

    The number of dose increases in anti-seizure medications (ASMs), including Epidiolex, due to adverse events or other factors.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  11. Frequency of adverse events of special interest (AESIs) after starting Epidiolex.

    Adverse events of special interest (AESIs) include: somnolence, sedation, appetite changes, gastro-intestinal upset (including diarrhea and vomiting), and transaminase elevations. Frequency of AESIs will be measured by determining the total number of AESIs experienced throughout the treatment period of the study.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  12. Severity of adverse events of special interest (AESIs) after starting Epidiolex.

    Adverse events of special interest (AESIs) include: somnolence, sedation, appetite changes, gastro-intestinal upset (including diarrhea and vomiting), and transaminase elevations. The severity of AESIs will be assessed as: "Mild - Events require minimal or no treatment and do not interfere with the participant's daily activities", "Moderate - Events result in a low level of inconvenience or concern", or "Severe - Events interrupt a participant's usual daily activity and may require therapy or other treatment". The total number of mild, moderate and severe AESIs experienced throughout the treatment period of the study will be determined.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  13. Duration of adverse events of special interest (AESIs) after starting Epidiolex.

    Adverse events of special interest (AESIs) include: somnolence, sedation, appetite changes, gastro-intestinal upset (including diarrhea and vomiting), and transaminase elevations. The duration of AESIs will be measured by calculating the length of individual AESIs experienced throughout the treatment period of the study.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  14. Withdrawal rate due to adverse events after starting Epidiolex.

    The withdrawal rate will be determined as the percentage of participants who withdraw from the study and discontinue Epidiolex due to adverse events.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  15. The change in frequency of seizure rescue medication use following transition from 'artisanal' CBD to Epidiolex.

    The percent change (increase or decrease) from baseline in 28-day seizure rescue medication use during the maintenance period. Rescue medication frequency will be calculated as the total number of doses of rescue medication administered divided by the number of days with diary data, multiplied by 28.

    Time frame: Baseline (visit 2, Day 1) through end of treatment (visit 7, Day 85).

  16. Change in Columbia-Suicide Severity Rating Scale (C-SSRS) score.

    The Columbia-Suicide Severity Rating Scale (C-SSRS) assess the risk of suicidal ideation and behaviour. The questions are divided into categories related to ideation (thoughts) and behaviour (actions). Higher scores indicate more serious/worse suicidal ideation or behaviors.

    Time frame: Baseline (visit 1, Day -28) through end of treatment (visit 7, Day 85).

Other outcomes

  1. Motivation for switching from 'artisanal' CBD to Epidiolex.

    The switching questionnaire consists of two multiple choice questions, along with an open-ended question designed to understand the caregiver's primary and secondary reasons for transitioning their child from 'artisanal' CBD to Epidiolex.

    Time frame: Baseline (visit 1, Day -28), once at beginning of study.

07

Study locations

1 site
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Start is estimated for Jan 2027; primary completion for Jan 2028, 12 months later.

How these figures are worked out, and which studies are left out of them.

Registered
Apr 4, 2025
First posted
Apr 11, 2025
StartEst.
Jan 1, 2027
Primary completionEst.
Jan 1, 2028
CompletionEst.
Jun 2029
Last update
Sep 11, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Sep 11, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT06924827
Lead sponsor
Elizabeth Donner
Responsible party
Elizabeth Donner (Head, Division of Neurology, The Hospital for Sick Children) — Sponsor-investigator
First posted
Apr 11, 2025
Start date
Jan 1, 2027 (estimated)
Primary completion
Jan 1, 2028 (estimated)
Completion
Jun 2029 (estimated)
Last update
Sep 11, 2026

Study contacts

Laura MacDougall, PhD
Contact
laura.macdougall@sickkids.ca
416-813-7996
Elizabeth Donner, MD
principal investigator · The Hospital for Sick Children

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Cannabidiol

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