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I wouldn't necessarily say telepathy is the same thing as hearing voices since its a form of communication that is done by otber means than the known senses.Regarding the distinction between telepathy and hearing, I don't think it matters much in this case? The victim will still be hearing It's voice in their head.
When Henry Bowers was stuck in prison, Pennywise used an illusion to project itself on the moon and used telepathy to talk to him, causing his mental state to degrade in the process.
And yeah, I don't see what Penny can do against passive life drain.
The thing is though AoC isn't made out of organic mater but of curses and since she is a witch she should have type 2 inorganic physiology so unless Pennywise has feats of being able to affect type 2 inorganic characters his madness haxs shouldn't be a problem.
Gonna wait for what others say for the life drain thing.