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New Vegas Tick Fix[www.nexusmods.com]
Yukichigai Unofficial Patch - YUP[www.nexusmods.com]
JIP LN NVSE Plugin[www.nexusmods.com]
JohnnyGuitar NVSE[www.nexusmods.com]
4GB Patcher[www.nexusmods.com]
New Vegas Anti-Crash[www.nexusmods.com]
Unofficial Patch NVSE[www.nexusmods.com]
Also, create an ini file named FalloutCustom.ini in \Documents\My Games\FalloutNV and paste the following but Replace INumHWThreads with the number of threads your CPU has!.
Verify that you have some form of vsync enabled. (iPresentInterval=1 in FalloutCustom.ini should do that, else try setting that from somewhere else like Nvidia control panel).
Also, open \Fallout New Vegas\Data\NVSE\Plugins\NVTF.ini and set the following:
bUseD3D9Ex=1
bUseFlipExSwapMode=1
iMaxFPSTolerance=180
Always install them manually by pasting the files in the game's folder.
xNVSE files such as nvse_***.dll should be extracted to the game's root directory.
NVSE plugins such as NVTF.dll, nvac.dll, jip_nvse.dll, johnnyguitar.dll should go to \Fallout New Vegas\Data\NVSE\plugins.
Then you always run the game by running NVSE_loader.exe, unless you have run the 4GB patcher which makes the game's exe do that by itself.
These can all be found on the Nexus. This video also helped me out. https://www.youtube.com/watch?v=Cypqage_Pdk
You can also find helpful .ini tweak guides.