On the Road: Live from Pittsburgh

John McManamy Health Guide
  • They have real towels in the hotel I am staying at. I slept on a king size bed that was so huge that if I kept rolling over and rolling over I would never reach the other side. I am wearing a hotel terry cloth bathrobe as I write this while sitting in an adjoining room off of the bedroom. Yes, I’m in a suite. I am actually looking out a window at a real view, not a brick wall or a parking lot.


    Wow, I bet the people who can afford these rooms don’t drive cars with 200,000 miles on them, either. I could very easily get used to this.


    Naturally, I’m not paying for the room. When I go to conferences, I’m usually in something in the two-star range. But the Seventh International Conference on Bipolar Disorder, hosted by the Western Psychiatric Institute and University of Pittsburgh, is picking up my tab this time around. Tomorrow evening, at a function, I will be one of three people that the conference organizers will be singling out.

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    It is very important that I mention all this. It’s called disclosure. You see, I’m going to start saying good things about the people I ran into at a pre-conference function last night.


    Yesterday, 6:00 PM: I’m in the lobby, waiting for transportation that will take us to the home of Ellen Frank and David Kupfer, two of the conference organizers. Steve Propst, chair of DBSA, joins us. At support groups, he challenges fellow patients by saying something along the lines of: “And then you get your meds right. And then what?”


    Recovery is way more than just meds, especially when all our current ones are based on 60-year-old technology.


    At the Frank/Kupfer residence, over drinkie-poos, I get into a discussion with Husseini Manji, head of the Mood and Anxiety Disorders unit at the NIMH. Over the years, Dr Manji has graciously walked me through brain science. Two weeks ago, at the American Psychiatric Association annual meeting, I heard a John Krystal from Yale expound on the fine points of glutamate, and I’m interested in Dr Manji’s take. He fills me in, but is quick to remind me that the real action is inside the neuron at the molecular level. Glutamate and other neurotransmitters work outside the neuron. All the brain systems, molecular and neurotransmitter, are linked, which in turn are linked to genes and the environment.


    We sit ourselves down at long wooden tables set up in the back yard. The man directly across from me introduces himself as Darrel Regier. “Just the man I want to meet,” I burst out. Dr Regier is co-chair of the APA’s DSM-V. The other co-chair is the function’s co-host, Dr Kupfer. The DSM-V, which is due to come out in 2012 at the earliest, is bound to have some significant changes that determine how we think about our illness over the next 20 years.


    Facing me from the end of the table is Carol Tamminga, an expert in schizophrenia from the University of Texas. Another person I’ve been dying to talk to. The schizophrenia researchers are informing bipolar research, which is one of the reasons she has been invited to speak at this conference. They are definitely ahead of the curve when it comes to studying cognitive impairments (which many bipolar patients also have). I heard her speak two weeks ago at the APA, where she observed that the schizophrenia and bipolar specialists rarely talk to each other.

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    Earlier in the evening, other experts have filled me in on what is going on with new drug development in the area of cognition. There are no current meds for this on the market, even though it is probably the main impairing feature of schizophrenia and looms large in bipolar. Some decent meds is this department may make the difference between people sitting in days rooms smoking cigarettes and suddenly coming to life and getting out into the world with something resembling a life. Meds like these would probably also help me, even more than the mood stabilizer I am on.


    Dr Tamminga further elaborates on these meds. I happen to ask what kind of time frame are we talking about before these meds get to market, assuming they pass all their trials with flying colors.


    Three or four years, she replies. Knock me over with a feather. We are looking at the possible introduction of the first true new psychiatric meds – not just tweaks on the old ones – in sixty years. Since, Thorazine, since lithium, since the first generation antidepressants.


    In the driveway, waiting for transportation back to the hotel, I get into a discussion with Thomas Insel, head of the NIMH. His enthusiasm for the new scientific discoveries taking place reaffirms what I have been hearing from people all evening. Let’s put it this way: I am sure this is how NASA space scientists felt back in the 1960s when they were shooting for the moon and beyond.


    We are living in exciting times. This is one reason I love my job.   

Published On: June 07, 2007