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My take: Despite the fact that every time I've used Spectral Razor I've got more than +9, Dread Curse of Azathoth is still the safest bet; you can't rely on getting 5 or more successes with Spectral Razoe, however Dread Curse of Azathoth suffers the drawback of being really easy to fail at casting it due to the -2, while Spectral Razor will alsmot always be cast, and even if you only get one or two successes on Spectral Razor it will still be better than the 0 successes and the loss of 2 sanity with Dread Curse of Azathoth. In conclusion: Spectral Razor is the better card in my honest opinion. Now you.