I use a custom version of Sh3speech, and I love it. I could never get the commands for the mouse to work, so I custimized the program to only handle key commands. Even there I did a fair amount of customizing. That still lets me control 75% or so with voice commands, the rest require clicks of the mouse. Here's a thread:
http://www.subsim.com/radioroom/show...ight=sh3speech
Once you've figured out how it all works, you'll find it is very 'customizable'.