Epstein-Barr virus therapy has limited options and is rarely available from your local family doctor. Most of the time you struggle with the usual standard medications until you possibly - if at all - end up seeing a specialist in immunology for the specialist clinical diagnosis of immune defects. Below I reported on my personal experiences after an Epstein-Barr infection in order to treat, mitigate or make the long-term effects more bearable. The list will be expanded bit by bit...
Amitriptyline
Amitriptyline is a drug from the group of tricyclic antidepressants that is primarily used to treat depression and long-term pain management. A 2001 review study called it the “gold standard antidepressant.” (Source: Wikipedia)
Do you already know it? Me too and no, I would never take it again. That in advance. I'll tell you about my personal amitriptyline experience here and won't go into the biochemistry. My family doctor prescribed it many years ago in a small dose (10 mg) to have a positive effect on chronic pain. It is known to be one of the few substances that can begin to treat neuropathic pain. Also the only therapeutic agent for fibromyalgia. It could also help against tinnitus and depression, it seemed ideal for me. In the end, cases like mine always end up with this active ingredient, what else can the doctor do?
Since I wanted to show compliance and the dose seemed appropriately low, I took the medication for four years. Always at night, as it should provoke tiredness. Well, with the appropriate dose it is always an individual matter. Should you do more or less? If in doubt, the only option is to test yourself. After two years I halved the dose because I had already gained 5 kilos and it didn't seem like it was doing anything for me. Due to the weight problem being a known side effect alone, I had no need to test a higher dose.
A few years later I went to the Sylt pain clinic for therapy and was given high doses of amitriptyline again, after consultation. High dosage in the sense of around 50 mg (of course slowly increased). Since my overall level of suffering was high at that time, I took this amitriptyline test again. Unfortunately, I couldn't deal with the severe side effects. The dry mouth is extremely unpleasant and I'm really talking about a desert. Above all, the rising inner unrest bothered me; I hate inner unrest. This is the worst feeling for me. So we took it off again. By the way, I can't report that it helped against fibro pain, headaches, migraines, or tinnitus.
I would like to add something else about the well-known amitriptyline side effects of dry mouth. Oral hygiene suffers greatly if you take the substance for a long time, even in small doses. To be on the safe side, I had to have my teeth cleaned every three months after some construction sites (i.e. tooth decay) developed unnoticed. Normally, each body produces up to 1.5 liters of saliva every day. Some medications reduce the flow of saliva to such an extent that it feels like hardly anything is happening. The oral cavity, oral mucosa, gums, teeth, etc. are correspondingly vulnerable to all bacteria and viral influences, because saliva normally also serves as protection.
Over time I was able to increase the check-ups to every six months and my dentist was able to repair any damage, but he would never want to take such medication again. If you take it, you should go to the dentist at least once a quarter and brush your teeth very carefully after every meal and also rinse your mouth with a hygiene rinse from the pharmacy! Even after drinking sugary drinks or candy!
Tramadol
Tramadol is a drug from the opioid group and is used to treat moderate to severe pain. The substance was developed synthetically by Grünenthal GmbH and brought onto the market in 1977 as a medicine under the name Tramal. (Source: Wikipedia)
My family doctor called Tramal “the little sister” of morphine when he prescribed it to me after my last ear operation (due to a traumatic rupture of the eardrum). Unfortunately, it was the best choice at the time because I was allergic to the otherwise effective and well-tolerated analgesic “Metamizole” (also Novaminsulfone). As a nursing professional, I have only ever dosed, presented or administered the “liquid” treats such as Tilidin, Tramal & Co and have never taken them myself. However, I can remember a nurse colleague who probably liked to use the tramal, which I couldn't understand at the time. For what reason? I used to feel guilty when I took an IBU 600 somewhere because of severe period pain or something like that to keep going. But BTM or its precursors? Whatever the W says. In any case, the odyssey began in the Hamburg hospital (2014) in the ENT department, after my third and so far last ear operation, the eardrum tympanoplasty. Very painful, very complex and of course accompanied by fatty inflammation. I had an operated ear like Benjamin Blümchen. In addition to days of IV antibiotics, I definitely needed adequate pain management, “pronto”. Anyone who has ever had to deal with nasty middle ear infections can probably guess what quality the pain was. The 10 according to NRS was almost not enough. What now? First of all, be careful that I don't come back! someone “accidentally” adds Novaminsulfone IV. This sometimes happens in a hurry and could be fatal for me, but there is always a bit of wastage. :)
Sisters at the patient's bed among themselves: “What do we do now? Novalgin doesn’t work.” Me: “No. What else do you have?”. You: “Tramal liquid?” Me: “Yeah, if not now, then when?” So every few hours I got my liquid dose, which shoots straight into every cell and makes life more bearable. First off! The pain disappeared and it was the only way I was able to survive the difficult operation and its complications. Unfortunately, with Tramal Liquid (in contrast to Tramal Long Retard tablets or similar) you are in an absolute addiction loop even after a few weeks. My Tramadol experience says: Not longer than one to two weeks and exclusively in acute situation take, then Discard leftovers! Chronic pain such as migraines, fibromyalgia etc. are associated with acute situations not meant , only surgical situations. I just didn't throw away the leftovers. Or I then asked my family doctor to prescribe the liquid devil's stuff for me, which he willingly did and continued.
Since I worked as a freelance writer mostly on deadline during this time, I automatically use the substance for my own purposes at some point. With an extra dose here and there, I was able to cover up depressive phases or give my body the illusion of strength to write. I was aware that this behavior was not necessarily good and I had high expectations of wanting to stop taking Tramal. This worked better and worse, especially since the order situation was exploding and I wanted to do everything that came in. In combination with the long-term consequences after the Epstein-Barr infection, the calculation no longer worked out. Fatigue syndrome had me firmly in its grip, and the vicious circle of medication revolved accordingly. At some point on this self-help homepage I already mentioned where the whole thing ended. A few years later I went to the addiction ward of a certain clinic on my own to get rid of the remaining 50 mg of Tramal. That doesn't sound like much, unfortunately it's difficult to complete Tramal withdrawal at home. I am very sensitive to inner restlessness and needed medical supervision, even short-term diazepam to counteract it. Even with that, the first three nights were horrible and the aftercare nurse had to be very supportive. I would like to recommend tramadol as an active ingredient only for short-term use in acute surgical situations, but not as a last resort for those chronically affected.
