If it is only working sporadically or not at all and you can see the cursor move, then you probably need to adjust your Clickmouse delays in Options > Settings > Clickmouse.

Check "Substitute SendWinS for SendWinM"
Change the Clickmouse delays to 10 10, 15 15 or 25 25 and try it. Adjust them up or down as needed. My system does fine on 6 6, but it really depends on who much is going on, how much you spam and the power of your system.