Seriously the newest patch has made the game unplayable. People who were running mods can't do jack anymore. My roommate modified my game's music files on me as a prank and because of this new update I can't even reach 20FPS anymore despite running at a smooth 60 prior to the patch. I don't know what Bethesda did with this recent patch but is seems to have made the game atrociously unoptimized and just generally awful.

Dxdiag report