Well, sort of.

I have a blacklist, the words are:
Viagra
cialis
levitra

saying any of these words will automatically delete your comment with no review

Any posts containing the following:
(urls of any kind)
article
mg
pharmacy
canadian
diet
thesis
medical
bets
bingo
poker
business
education
doctor
download
content
traffic

will be held for moderation, and that is in any form, for example fhkgbdkhbfhkviagrafdhbdhkbf will still be read as viagra, and also words like wormgear, will be enterpreted as mg.
I dont think links will be detected if they dont have hyperlink formatting, but ill be checking fairly often so, it shouldnt be an issue with urls anyway.

Most spam has been screwed up now that i disabled the website url field in comments, bots are pasting the website in the comment itself and will continue to get caught out by my manual spam filter.  If some slip through i can just up the moderation whitelist. More readers might get caught up in the filter but, no matter what the majority will have comments go through instantly, and even when 100% of comments had to be approved, it still worked out ok.