I've seen a variety of threads for this issue, some with potential fixes but none that worked for me.

The game used to run fine but I recently reinstalled it after not playing for a while and ran into the issue of the game not running faster than 45-50 FPS. This has a pretty major impact on gameplay.

Things that I've tried that have not fixed the issue:
- Extracting the Downwell executable and modifying options.ini changing AlternateSyncMethod to =1
- Uninstalling / reinstalling Downwell
- Going to the beta release
- Enabling / Disabling gsync/freesync (normally on)
- Enabling / Disabling vsync in driver settings (normally off)
- Enabling / Disabling vsync in the game (normally off)

If anyone knows of any other solutions please let me know.

I've reached out to Devolver for support and I will update this with any info they can provide. I'm honestly not expecting much but maybe they will surprise me.