It often helps with screen tearing on a variety of cards. You can also try RivaTuner Statistics Server.
If windowed mode is better, you can use the Windowed Borderless app, which works very well with TS3. You can also try switching between fullscreen and windowed modes, again with Inspector in the picture since CP won't work. Since you're on patch 1.69, be sure to use TS3.exe, not the one with the W in it, to set up the profiles. Settings for Inspector are in this post, under the second spoiler: ('fps off' makes it go away.) If it's running too high, you can add Nvidia Inspector (free download) to the mix-I'm guessing your Alienware has an Nvidia card?-to see if it helps. The number will appear in the upper right corner of your screen. Check your in-game fps to make sure it is in fact locked to the refresh rate of your screen: Bring up the cheats console (crtl-shift-c) and enter 'fps on' without quotes. You may have v-sync on, but you can try fiddling with the settings, for example switching from 'on' to 'adaptive.' The Control Panel settings don't always work though, and never work in windowed mode.
