Prevalence of propranolol use and self-prescription and its association with anxiety among medical students in Egypt: a cross-sectional study

Abstract

Beta-blocker medications, such as propranolol, are increasingly used, yet self-prescription rates and their link to anxiety among Egyptian medical students are underexplored. The current study aimed to determine the prevalence of propranolol use, including the proportion of self-prescription, and evaluate its association with anxiety in Egyptian medical students. A cross-sectional study was conducted among students across four medical colleges in Egypt from February 1, 2023, to February 28, 2023. Data were collected via a questionnaire that examined baseline characteristics, past medical history, utilization patterns, and knowledge of propranolol, along with an evaluation of anxiety levels using the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. The study included 508 medical students. A substantial 76% of the participants reported varying degrees of anxiety symptoms. Of the sample, 16.3% admitted to using propranolol. The most common source of students’ knowledge of propranolol is through study materials (73.5%). The primary motivation for Propranolol use was to alleviate anxiety, particularly during exam seasons (38.6%). The most reported adverse effects were hypotension, fatigue, disturbed sleep, and shortness of breath. Logistic regression analysis demonstrated that higher GAD-7 scores (OR 1.25; 95% CI 1.07–1.47), increasing age (OR 1.29; 95% CI 1.07–1.47), presence of chronic disease (OR 2.62; 95% CI 1.39–4.92), and being an ex-smoker (OR 5.88; 95% CI 1.48–23.38) were significant predictors of propranolol use. Self-prescribed use of beta-blocker drugs without medical supervision is evident among medical students in Egypt. Our findings indicate a significant association between anxiety symptoms and propranolol use among medical students. However, causal relationships cannot be established based on the current study design. Promoting responsible medication use and prioritizing medical students’ mental well-being through targeted interventions and support is crucial.