Does cannabis alleviate tinnitus? A review of the current literature

OBJECTIVE(S): Endocannabinoid pathways have been proposed to affect the underlying pathophysiology of tinnitus. The aim of this study is to evaluate the scope and findings of existing literature on the relationship between cannabis and cannabinoid pathways and tinnitus. METHODS: We conducted a review of animal, clinical and survey studies investigating the relationship between the use of cannabis‐derived agents and tinnitus. Using pertinent keywords and MeSH terms on PubMed, relevant studies were identified, yielding four animal studies, two large cross‐sectional survey studies, one clinical cross‐over study, and one case report. RESULTS: Animal studies revealed that cannabinoid receptor expression in the cochlear nucleus varied with tinnitus symptomatology and the use of cannabinoid agents either increased or had no effect on tinnitus‐related behavior. Survey studies yielded conflicting results between cannabis use and tinnitus in the general population. Clinical data is largely lacking, although a small cohort study showed a dose‐dependent relationship between tetrahydrocannabinol consumption and frequency of tinnitus episodes in patients receiving treatment for cancer. CONCLUSION: While animal studies have revealed that cannabinoid receptors likely have a role in modulating auditory signaling, there is no compelling data either from animal or human studies for the use of cannabinoids to alleviate tinnitus. Further research is necessary to elucidate their precise role to guide development of therapeutic interventions. LEVEL OF EVIDENCE: NA.