Depends on severity: Initially, may be best to use a Dopamine agonist (ropinorole, pramipexole, etc). Later l-dopa, and maybe add entacapone. If severe, and over 5-7 yrs, perhaps deep brain stimulation. Azilect (rasagiline) may be useful at times. In essence, different meds may be used best at different stages. This is the "art of medicine".
Answered 11/25/2014
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