I also recommend doing a PageDefrag at least once, in addition to your regular defragmenter.
http://technet.microsoft.com/en-us/sysinternals/bb897426.aspx
PageDefrag can analyses your system paging files and registry hive files for fragmentation and have them defragmented upon reboot. This is an area that can't be touched while Windows is running and is typically ignored by defragging tools.
De fragle rock
PageDefrag, first thing. Set the swap file to 2x the amount of RAM (fixed), then run pagedefrag to make that contiguous. Cuts down on thrashing, improves performance.
What I would do...
Or if you're in the mood for it, do a whole re-format and re-install of the OS. Immediately do #4 and #5 above if you do this.