Abstract

Background: Medical students are particularly vulnerable to psychological distress due to the academic intensity and emotional demands of medical education. The sudden transition to online learning during the COVID-19 pandemic posed additional challenges, increasing the risk of anxiety and maladaptive coping behaviors. This study aimed to assess the prevalence of anxiety and identify coping strategies used by medical students in Riyadh, Saudi Arabia, during the shift to online learning, with a focus on the use of pharmacological coping methods.
Methods: A cross-sectional descriptive study was conducted among 300 undergraduate medical students in Riyadh using a structured self-administered online questionnaire. Anxiety levels were measured using the Generalized Anxiety Disorder 7-item scale, and coping strategies were evaluated using items adapted from the Brief COPE inventory. Descriptive and inferential statistics were applied using Statistical Package for the Social Sciences version 26.
Results: The findings revealed that 42.0% of participants experienced moderate to severe anxiety. Perceived stress was significantly higher during online learning (M = 2.8, SD = 1.0) compared to traditional learning environments (M = 2.4, SD = 0.9; p < 0.001). A small proportion of students (9.3%) reported self-medicating with anti-anxiety drugs such as benzodiazepines, pregabalin, and propranolol, primarily during exams or public presentations. While some students perceived temporary relief, others reported no improvement or worsened anxiety symptoms.
Conclusion: Anxiety was highly prevalent among medical students in Riyadh during the transition to online learning, underscoring the psychological impact of this educational shift. The misuse of anti-anxiety medications highlights the urgent need for institutional mental health programs, counseling services, and educational interventions that promote healthy coping mechanisms. Enhancing psychological resilience and awareness among medical
students is essential to foster well-being and prepare emotionally competent future healthcare professionals.

Key words: Anxiety, Coping Strategies, Medical Students, Online Learning, Self-Medication, Saudi Arabia.