i found it easiest to play with three, got a couple keybind that allow me to spread two of them, then i move with the "main" freely. So we end up like a triangle shape. You have to spread them, or else the big circle aoe that appear around each character will remove the sanity and health extremely fast. i did this around 370 ilvl++ and it was pretty smooth sailing to the boss. Trashmobs "barely" did a dent, if i avoided the mechanincs. 1 healer/dps + 2 dps, was what i used. Just walked along the leftmost side in orgrimar, took out those few mobs and then the two bigger guards by the door leading in to the bossroom.