Delete all the spammer accounts...
Add questions. Add 20-30 GOOD questions and ask 1-2 during registration
(there are several threads around which indicate some suggestions on how to construct good questions -- but the core of it is: Ask questions that can not be answered by a simple google search, since the bots can actually do that these days (aka "what color is a blue bird" is a BAD question...)
You can also use some of the additional mods like Bad Behavior, HttpBL, and Stop Forum Spam/Stop Spammer
CAPTCHA in general is worthless.... reCAPTCHA is still about 60% effective.
basically, good questions are the answer. With a set of good questions, I have not had a single bot-spammer register in 3 years.