Brief Answer: Preffrably change the drugs Detailed Answer: hello and welcome to HCM! i have read your question carefully and see that you are on bystolic and metformin. You have complaints of mood changes, joint pains etc since you started them. I can say form my clinical experience that - 1: nevibilol ( bystloic ) is safer than other beta blocker , but then also it has a potnetial to cause depression ( mood changes), leathgy, dizziness etc. 2. metformin has significant gastric side effects and can also lead to acidosis- irritability etc. When both are taken together, there can be increased episodes of hypogylecemia, and other above mentioned side effects. So, overall- from the time you have started on this combination, you have many adverse effects ( highly related to the drugs). Had I been at your place, I would have gone to my doctor again and discussed these points and got them change preffrably. Hope the reply is useful Feel free to ask more questions for clarifictaion if you are satisfied, kindly rate the answer and close the question Dr. Manisha Gopal MD psychiatry

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