After a lot more tinkering, I managed to figure this out on my own.
It seems that WinEQ2 was the source of most (but not all) of my problems, and getting rid of it helped significantly. I also had to disable all the checkboxes in the OptionsEditor tool except for Texture Caching, even having Sound enabled would give the slightest hint of choppiness. Adding vsync=TRUE to my eqclient.ini resolved any screen tearing once the frame rate was sorted out.
I also learned that using the rotation on the character select screen is always choppy no matter what. I had to fully log in to see my true performance.
So, to summarize, in order to achieve 60fps I had to:
1) Get rid of WinEQ2
2) Disable all checkboxes except for Texture Caching in OptionsEditor
3) Add vsync=TRUE to eqclient.ini
4) Log in completely to see the results
Hope this helps!
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