People with alcohol dependence sometimes develop cognitive brain changes or dementia that limit the usefulness of benzodiazepines in detoxification. Memantine, an N-methyl-D-aspartate receptor channel blocker, is postulated to reverse the up-regulation of N-methyl-D-aspartate receptor functions associated with prolonged heavy use of alcohol and has been shown to reduce alcohol craving. We report the case of a 65-year-old man with alcohol dependence, cognitive impairment, and persistent craving for alcohol after detoxification in whom craving and cognitive impairment were significantly improved on treatment with memantine.