What is the best medicine or stimulation surgety for parkinson disease?

Meds First, then DBS: As a pd specialist i always try to get the most utility from medications first. The typical choics are (in order of preference): azilect, agonists (requip xl, Mirapex er & neupro-available july 16), then sinemet & last comtan (entacapone). If despite all these, symptom relief/qol is poor, dbs of stn or gpi ate favored & are very effective @ reducing inconsistent medication effect (.