If you know what you are doing, I have found "hijack this" to be a really effective tool.
It lists out pretty much everything going on in your computer and you can get rid of anything you want from their screen. Unfortunately, it does not distinguish good from bad so you can end up fucking yourself if you go overboard.
The spyware/adware checkeres help, but they are only as current as their last database update.
To clean up, I normally run spybot and let it clean up what it finds, then adaware and let it clean up. Then I run hijackthis and remove anything I do not recognize as being ok. This is where most of the time comes in because when I am in doubt, I do a search on what file I am getting ready to turn off before so I can see what it is associated with before I kill it.
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