So, Rindis and I have been poking a little (okay, a lot) at Neverwinter lately. While it's not great, it is pretty decent, and is completely free to play. However, Rindis being on an older system, was having trouble. So we sat down one night and did some benchmarking (based off of FPS during combat).
We found that keeping it on Basic Video only setting, keep the Render setting all the way up on Quality, yank the Graphics setting all the way to the bottom, then (using the little arrow on the right) click it up once. We have found this being the best performance vs. quality graphic in the game.
If you can't run the game on full, give these a try.
Oh, and if you have Steam, turn it off. Dang that things a hog. T-T