Psychotropic and pain medications are vital for mental and neurological disorders, but in Muslim-majority settings, their use is influenced by religious beliefs, stigma, and cultural attitudes. To assess public knowledge, attitudes, perceptions, and behaviors related to psychotropic and neuroactive medications among Saudi adults, and identify demographic and psychosocial predictors. An online survey of 1,033 Arabic-speaking adults in Saudi Arabia used questionnaires including the Mental Health Knowledge Schedule, Drug Attitude Inventory, Beliefs about Medicines Questionnaire, and a new Islamic Perception Scale. Descriptive statistics and regression analyzed predictors of knowledge, Islamic permissibility perceptions, and behaviors. Most participants were Saudi (88.4%), female (81.9%), and under 30 (66.9%). Knowledge was mainly moderate (53.7%), with 33.8% low and 12.6% high. Attitudes were mostly neutral (56.6%), and Islamic permissibility perceptions were moderate primarily (67.1%). Hesitant or conditional behaviors appeared in 67.8%. Previous prescribed use was linked to greater knowledge; age, residence, and education influenced perceptions of permissibility behaviors, which varied by sex, profession, religious literacy, knowledge, attitudes, and Islamic views. Mental health literacy, religious perceptions, and sociodemographic factors shape attitudes and behaviors, underscoring the need for integrated, religion-informed mental health education and policies in Saudi Arabia.
