The game engine is really old, why everyone is waiting for UE4 update so your not always going to get great fps.
You can try allot of things to help though.
-Run Shadows Visibility at 2
-Run Shadow Level at 2
-SFX Quality for others at 1 {you dont need them to look good just you}
-Monster Effects Quality at 2 {some run at 3}
-Background Effects at 2 {no pixie dust effects where your not focus on}
-Extra Effects at 2
Turn off Motion blue and Depth of field, I keep bloom on just my personal taste. Keep all Speacial Effects off and for god dont use the games Anti-Aliasing its just bad.
This should help you with some basic FPS but now your game doesnt look as great but its a trade for FPS. Looks good=bad fps / Looks bad=greatfps.
There are VPNs you can also try like ping zapper or exit lag{I like} but depending how far you are from Ashburn, Virginia it might or might not help.
You can change your Nvidia settings to help but from what I tested the game engine is so out of date it dont really matter what you got in there. I only got about 1-5fps more editing profiles for that.