I installed Block-Spam-By-Math-Reloaded a month back as I was getting some spam and so far, I haven't received any spam. It's not that advance really, it just asks a math question at the end of the comment box, unless the person is logged in then it doesn't bother them (but I have open registrations off anyway)
Using a combination of akismet, captcha I end up with very little spam. You still have to manually moderate the comments, as you will still receive spam, but at least this way you wont end up on any spammers lists.