Try turning off Throttle and turning on Sync to Monitor Refresh. Leave everything else (TB/Vsync/RefreshSpeed) off. This is how I do it, and it's perfectly smooth.
If your display is at a higher refresh rate than the game, you should be set. Note that this can significantly increase the speed of some games (R-Type, going from 55hz to your display's 60hz), but for most games, the speed difference is imperceptible.
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