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Asda Colleague Handbook Our 50th birthday is a great opportunity to not only thank our customers and colleagues for their support over the years, but also to show. A Colleagues 'holiday top up hours' will also increase or decrease accordingly where their holiday entitlement changes due to any changes to their contracted hours during the holiday year.
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Methylphenidate (MPH; also Ritalin, Concerta, Metadate or Methylin) is a psychostimulant drug approved for treatment of attention-deficit hyperactivity disorder, Postural Orthostatic Tachycardia Syndrome, and narcolepsy.
Originally it was marketed as a mixture of two racemates, 80% (±)-erythro and 20% (±)-threo. Beginning in the 1960s, it was used to treat children with ADHD or ADD, known at the time as hyperactivity or minimal brain dysfunction (MBD).
Most brand-name Ritalin is produced in the United States, and methylphenidate is produced in the United States, Mexico, Argentina, and Pakistan.
Another medicine is Concerta, a once-daily extended-release form of methylphenidate, which was approved in April 2000.
Methylphenidate is approved by the FDA for the treatment of attention-deficit hyperactivity disorder[21] The addition of behavioural modification therapy (e.g.
Narcolepsy, a chronic sleep disorder characterized by overwhelming daytime drowsiness and sudden attacks of sleep, is treated primarily with stimulants.
Methylphenidate has shown some benefits as a replacement therapy for methamphetamine addicts.[36] Methylphenidate and amphetamine have been investigated as a chemical replacement for the treatment of cocaine dependence[37][38][39] in the same way that methadone is used as a replacement for heroin. Early research began in 2007-8 in some countries on the effectiveness of methylphenidate as a substitute agent in refractory cases of cocaine dependence.
Given the high comorbidity between ADHD and autism, a few studies have examined the efficacy and effectiveness of methylphenidate in the treatment of autism.
The sample included 33 children with pervasive developmental disorder (29 boys) with a mean age of 6.93 years (range 5-13). The results indicate that children showed significantly more joint attention behaviors when receiving methylphenidate than when receiving the placebo (although the most effective dosage varied by individual). Animal studies using rats with ADHD like behaviours were used to assess the safety of methylphenidate on the developing brain and found that psychomotor impairments, structural and functional parameters of the dopaminergic system were improved with treatment. Young people have been prescribed ritalin have been known to sell on the tablets to other young people who take the drug recreationally. Ritalin is used by students to enhance their mental abilities, improving their concentration and helping them to study. A 2003 study tested the effects of dextromethylphenidate (Focalin), levomethylphenidate, and (racemic) dextro-, levomethylphenidate (Ritalin) on mice to search for any carcinogenic effects. The effects of long-term methylphenidate treatment on the developing brains of children with ADHD is the subject of study and debate.[69][70] Although the safety profile of short-term methylphenidate therapy in clinical trials has been well established, repeated use of psychostimulants such as methylphenidate is less clear. Methylphenidate should not be prescribed concomitantly with tricyclic antidepressants, such as desipramine, or monoamine oxidase inhibitors, such as phenelzine or tranylcypromine, as methylphenidate may dangerously increase plasma concentrations, leading to potential toxic reactions (mainly, cardiovascular effects). The United States Food and Drug Administration gives methylphenidate a pregnancy category of C, and women are advised to only use the drug if the benefits outweight the potential risks.[91] Not enough animal and human studies have been conducted to conclusively demonstrate an effect of methylphenidate on fetal development.
Methylphenidate has both DAT and NET binding affinity, with the dextromethylphenidate enantiomers displaying a prominent affinity for the norepinephrine transporter. The enantiomers and the relative psychoactive effects and CNS stimulation of dextro- and levo-methylphenidate is analogous to what is found in amphetamine, where dextro-amphetamine is considered to have a greater psychoactive and CNS stimulatory effect than levo-amphetamine. The means by which methylphenidate affects people diagnosed with ADHD are not well understood.
It is commonly asked why a stimulant should be used to treat hyperactivity, which seems paradoxical. One study finds that methylphenidate reduces the increases in brain glucose metabolism during performance of a cognitive task by about 50%.
A paper published in Biological Psychiatry reports that methylphenidate fine-tunes the functioning of neurons in the prefrontal cortex - a brain region involved in attention, decision-making and impulse control - while having few effects outside it. Methylphenidate is a drug of abuse.[121] Methylphenidate like other stimulants increases dopamine levels but at therapeutic doses the increase is slow and thus euphoria does not typically occur except in rare instances.

Methylphenidate's pharmacological effect on the central nervous system is almost identical to that of cocaine.
In the United States, methylphenidate is classified as a Schedule II controlled substance, the designation used for substances that have a recognized medical value but present a high likelihood for abuse because of their addictive potential. In the United Kingdom, methylphenidate is a controlled 'Class B' substance (the same category as Cannabis), and possession without prescription is illegal, with a maximum sentence of prison.
Methylphenidate (usually referred to by the brand name Ritalin) has been the subject of controversy in relation to its use in the treatment of ADHD. Richard Bromfield claims that Ritalin is often prescribed not because of an underlying neurological disorder, but as an easy way to calm down children whose misbehavior actually results from ordinary causes such as bad parenting. Mike and Dean Thompson, a father and son duo from our Clayton Green store, have really gone above and beyond to be crowned worthy winners of the Colleague of the Year Award at the Asda Awards. The Handbook states: "To ensure that all Colleagues can take at least their statutory minimum entitlement to paid leave in any holiday year, at or around the beginning of each holiday year Asda (or it's payroll provider) will calculate the total number of potential additional hours paid holiday any affected colleagues would have a statutory entitlement to take if they had no paid time off during the holiday year in question on a Customary Holiday they are contracted to work but not required to work. Colleagues who are not potentially affected by the increases in statutory minimum holiday entitlements will not have 'holiday top up hours' line shown on their payslip. It may also be prescribed for off-label use in treatment-resistant cases of lethargy, depression, neural insult, obesity, and rarely other psychiatric disorders such as Obsessive-Compulsive Disorder.
It can also improve depression in several groups including stroke, cancer, HIV-positive patients.[33] However, benefits tend to be only partial with stimulants being, in general, less effective than traditional antidepressants and there is some suggestive evidence of a risk of habituation.
That it can satisfy cravings for cocaine in a way that is subjectively and pharmacologically equivalent but longer-lasting as well as easier on the body and somewhat safer and easier to manage has long been part of the 'street lore' associated with stimulants in many parts of the world. However, most of these studies examined the effects of methylphenidate on attention and hyperactivity symptoms among children with autism spectrum disorders. This was a 4-week randomized, double-blind, cross-over placebo study, with treatment changing each week between 4 conditions: placebo, low dose, medium dose, and high dose. Furthermore, at a group level, the low dose of methylphenidate resulted in significantly improved joint attention behaviors when compared to the placebo, but no differences were noted between the low, medium, and high doses. This animal data suggests that methylphenidate supports brain development and hyperactivity in children diagnosed with ADHD. In the UK it has been dubbed "kiddie coke" due to its low price and high availability amongst young people.
Professor John Harris, an expert in bioethics has said that it would be unethical to stop healthy people taking the drug. The researchers found that all three preparations were non-genotoxic and non-clastogenic; d-MPH, d, l-MPH, and l-MPH did not cause mutations or chromosomal aberrations.
Methylphenidate should not be prescribed to patients who suffer from severe arrhythmia, hypertension or liver damage.
Some researchers have theorized that ADHD is caused by a dopamine imbalance in the brains of those affected. This suggests that, similar to increasing dopamine and norepinephrine in the striatum and prefrontal cortex, methylphenidate may focus activation of certain regions and make the brain more efficient. The team studied PFC neurons in rats under a variety of methylphenidate doses, including one that improved the animals' performance in a working memory task of the type that ADHD patients have trouble completing. The abuse potential is increased when methylphenidate is crushed and snorted or when it is injected producing effects almost identical to cocaine. In many such cases the child exhibits symptoms because it has become the identified patient in the family. Any potential additional hours resulting from this calculation will be shown on the payslip as 'holiday top up hours' and will decrease during the holiday year if the colleague has any paid time off on a Customary Holiday that they are contracted to work but not required to work. Methylphenidate belongs to the piperidine class of compounds and increases the levels of dopamine and norepinephrine in the brain through reuptake inhibition of the monoamine transporters. There have been no placebo controlled trials investigating the long term effectiveness of methylphenidate beyond 4 weeks thus the long term effectiveness of methylphenidate has not been scientifically demonstrated. This is similar to the way that other substitution drugs such as methadone, buprenorphine, LAAM, butorphanol, extended-release oral morphine, dihydrocodeine, and clonidine were amongst opioid users in various times over the past century. In this design, neither the experimenters nor the families know which of the 4 treatments the child is receiving at any given time. Low and medium doses of methylphenidate also resulted in improved self-regulation behavior when compared to placebo. However, in normal control animals methylphenidate caused long lasting changes to the dopaminergic system suggesting that if a child is misdiagnosed with ADHD they may be at risk of long lasting adverse effects to brain development.

In the USA it is one of the top ten stolen prescription drugs and is known as "Vitamin R" and “The R Ball”. He also argues that it would be "not rational" and against human enhancement to not use the drug to improve people's cognitive abilities.[47] Professor Anjan Chatterjee however has warned that ritalin has a high potential for abuse and has serious adverse effects on the heart meaning that only people with an illness should take the drug. Nonetheless withdrawal reactions may still occur in susceptible individuals.[86] The withdrawal or rebound symptoms of methylphenidate can include psychosis, depression, irritability and a temporary worsening of the original ADHD symptoms. It shouldn't be prescribed to patients who demonstrate drug-seeking behaviour, pronounced agitation or nervousness.[28] Care should be taken while prescribing methylphenidate to children with a family history of Paroxysmal Supraventricular Tachycardia (PSVT). However, this was a cardiac malformation, which was not within the statistically expected range.[94] Finally, in a retrospective analysis of patients' medical charts (N = 38), researchers examined the relationship between abuse of intravenous methylphenidate and pentazocine in pregnant women. Methylphenidate is a norepinephrine and dopamine reuptake inhibitor, which means that it increases the level of the dopamine neurotransmitter in the brain by partially blocking the dopamine transporter (DAT) that removes dopamine from the synapses.[109] This inhibition of DAT blocks the reuptake of dopamine and norepinephrine into the presynaptic neuron, increasing the amount of dopamine in the synapse. This is consistent with the observation that stimulant drugs can enhance attention and performance in some individuals. Using microelectrodes, the scientists observed both the random, spontaneous firings of PFC neurons and their response to stimulation of the hippocampus. The contention that methylphenidate acts as a gateway drug been discredited by multiple sources,[133][134] though this point is still under debate.[135] Smoking tobacco also appeared to increase the risk of cocaine abuse in this population but even after controlling for tobacco exposure cocaine abuse was still significantly higher in adults who had been medicated with stimulants as children. They endured extreme weather conditions and terrain whilst carrying their equipment and supplies, all with the aim of raising money for Rosemere, a local cancer charity close to many colleagues’ hearts.
Colleagues are not allowed to book or take any hours shown on their payslip as 'holiday hours top up' until after the second Sunday in January in any holiday year. Ritalin is also sold in the United Kingdom, Germany and other European countries (although in much lower volumes than in the United States).
In addition, the treatment condition changes randomly each week, without anyone knowing the nature of the old or new condition.
Animal tests found that rats given methylphenidate grew up to be more stressed and emotional. Twenty-one percent of these children were born prematurely, and several had stunted growth and withdrawal symptoms (31% and 28%, respectively). If brain resources are not optimally distributed (for example, in individuals with ADHD or sleep deprivation), improved performance could be achieved by reducing task-induced regional activation. When they listened to individual PFC neurons, the scientists found that while cognition-enhancing doses of methylphenidate had little effect on spontaneous activity, the neurons' sensitivity to signals coming from the hippocampus increased dramatically.
As moderate doses of cocaine have caffeine-like effects and benzocaine produces a slight stimulant effect of its own perhaps 5 per cent the strength of cocaine with a ceiling in that range, the mixture is reported to have at least some of the sought-after effects. In Belgium the product is sold under the name "Rilatine" and in Brazil and Portugal as "Ritalina".
The dose, therefore, should be titrated to an optimal level that achieves therapeutic benefit and minimal side-effects.[27] Therapy with methylphenidate should not be indefinite. This allows the experimenters to assume that consistent changes in behaviors that occur during a particular treatment is truly due to the effect of that treatment and not to the expectation of the treatment (placebo effect). Finally, it increases the magnitude of dopamine release after a stimulus, increasing the salience of stimulus.
Methylphenidate is actually more potent than cocaine in its effect on dopamine transporters. Since the threo isomers are energetically favored, it is easy to epimerize out any of the undesired erythro isomers. Family history of mental illness does not predict the incidence of stimulant toxicosis in ADHD children.
Methylphenidate should not be viewed as a weak stimulant as has previously been hypothesised.[122] The primary source of methylphenidate for abuse is diversion from legitimate prescriptions rather than illicit synthesis. High rates of childhood stimulant use is found in patients with a diagnosis of schizophrenia and bipolar disorder independent of ADHD.

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