Battling WP_Options Bloat

I am a battling wp_options bloat issue that slows my site quite a bit. I use the Optimize DB plugin by Joost de Valk and that helps a ton (big thanks to Joost)! However, I have to MANUALLY hit the optimize button everytime and I have to do it almost everyday.

Would it be possible to somewhat easily add an auto-run every X hours to this plugin?

The wp_options bloat is probably due to inactive or removed plugins. The Clean Options plugin (http://www.mittineague.com/dev/co.php) attempts to address this but I have not used it and I worry about it potentially removing something important and causing further problems

Does anyone know how to best handle this problem with minimal risk to screwing up something the database?

Thanks for your time and help, it is greatly appreciated.