I'd already gone through all the steps to get FEAR running, and Q4 worked fine stright away.
Steps for FEAR were:
- Uninstalling ACE Mega Codecs Pack
- Uninstalling updated SoundBlaster drivers
- Disabling any virtual-CD software
- Installing WMFADist.exe off the CD
- Removing the cthelper process
- Turning off EAX
- CIIJASIIE