Cognitive Enhancers Consumption: Prevalence, Knowledge, and Determinants of use among medical students in Egypt, Sudan, and Jordan. A multicentric cross-sectional study

Abstract Background: Cognitive Enhancers (CE) are central nervous system stimulant medications. These substances are known to improve cognitive functions. Due to high-perceived stress and academic pressure, CEs are becoming increasingly popular among university students, especially medical students. As a result, they are more likely to misuse these substances. Existing data in this area is limited, particularly in Egypt, Sudan, and Jordan. Objectives: This study aims to estimate the prevalence of CE consumption, compare the prevalence between countries and genders, and identify characteristics associated with CE consumption among students at medical schools in Egypt, Sudan, and Jordan. Methods: A population-based survey study was conducted among medical students from Egypt, Sudan, and Jordan. An online self-reported questionnaire was used to collect data. Frequencies and percentages were calculated to represent participant distribution across categories. Chi-square was used for categorical variables comparisons. All tests were two-tailed, considering p < 0.05 statistically significant. Demographic characteristics, reasons for use, types of CE used, frequency, and irregularity of sleep were compared by country and gender. Results: The questionnaire was filled out by 1399 medical students, most of whom were females 824 (58.9%). Overall, 1236 (88.3%) were CE consumers, and 163 (11.7%) were non-consumers. Of the respondents who used CE, 814 (58.2%) reported using them daily. There was a statistically significant difference between the consumption of CE and the source of acquisition, Nationality, and residence status in terms of gender. Ginkgo Biloba was more consumed by males(P<0.001), while Omega 3 and vitamin B12 (P=0.023) were typically taken by females. Most consumers were in their second year and fourth year. The most reported Side effects were headache and anxiety (P<0.001). Conclusion: The findings of this study suggest that CE use is increasing among medical students in Egypt, Sudan, and Jordan. Efficient support, stress management programs, and awareness symposia may help reduce the misuse of these substances.