A simplistic perspective on the complex relationship between schizophrenia and pain from dopamine excess

Schizophrenia is characterized by a paradoxical pain experience: the threshold for nociceptive pain is high, while the threshold for nociplastic pain is low.This phenomenon involves mesolimbic dopamine excess.Increased dopamine stimulates descending pain inhibitory pathways, alleviating nociceptive pain.However, dopamine excess induces changes in the large-scale brain network that generates nociplastic pain.This imbalance of monoamines, which is characteristic of schizophrenia, influences both psychotic symptoms and the unique pain paradox.Our results suggest that modulating dopamine levels appropriately may normalize pain thresholds and improve quality of life.