Could you use the waste heat to boil something and then spray it out the back as extra reaction mass?
Now, since you you can be boiling pure hydrogen rather than the water that comes out of a chemical rocket you can make the propellant faster. But you're limited in temperature by what your reactor can take without melting so that only buys you a power of 2 or so in efficiency.
I wrote a series about how the different types of rockets compare starting here: http://hopefullyintersting.blogspot.com/2015/03/rockets-some...