An Amulet of Blood Rage is a magic item that binds a willing person to a vampire. The person gets extra damage to melee strikes, while the the vampire gets a constant source of vitality.
It is typically an amulet with decorations relevant to the vampire's history. At the start of a combat, the wearer must cut themselves and press the amulet to it as a bonus action. The blood soaks into the amulet and then vanishes as the vampire feeds on it remotely. The wearer takes their level in damage and goes into a Blood Rage. The rage lasts until the wearer successfully ends the rage by making a CHA ability check at the start of their turn - the DC is 8+ whatever their current damage bonus from the amulet is. If they walk through running water or feel direct sunlight in a turn, they immediately must make a check with advantage - on a success, the rage ends.
When the rage starts, the wearer's eyes turn red and blood drips from their eyes like tears. The first time any creature of CR5 or less comes within 30 feet of the wearer, they must make a WIS saving throw with a DC of 13 or suffer from the frightened condition. They can roll again at the end of every turn to recover.
While the rage lasts, the wearer gets a damage bonus equal to their proficiency bonus to every melee attack. If the wearer does the killing blow to a foe that has was alive and has blood, they bite and drink blood from the corpse and then gain an extra +1 damage bonus from then on - up to a maximum of proficiency bonus +5.
While in a rage, the wearer must first attack foes that have blood then foes with no blood (DM discretion if attacking blood foes is tactically dangerous), then they will attack the nearest friends who have blood. They will not stop killing until they end their rage.
Once the amulet is put on, it cannot be removed except by the vampire choosing to remove it. Or possibly a high-level intervention by a magic user at the DM's discretion. Hardcore mode: if the vampire dies, the wearer of the amulet dies too.
If the wearer does not regularly go into a blood rage and feed their patron, then they start to get exhausted - one level of exhaustion for every week they haven't used it, for instance. Also the patron can appear to the wearer in dreams, deepening their relationship and asking the wearer to kill more powerful creatures - each death increases the power of the vampire. The vampire might offer more of their powers on a temporary basis - spider walking, turning into bats, etc).
Notes: doing a deal with a vampire, which magically binds you to them, after which you cannot willingly harm them and they become a patron of sorts.
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