This paper presents a prototype integrated bidirectional stimulator ASIC capable of mixed opto-electro stimulation and electrophysiological signal recording. The development is part of the research into a fully implantable device for treating motor neurone disease using optogenetics and stem cell technology. The ASIC consists of 4 stimulator units, each featuring 16-channel optical and electrical stimulation using arbitrary current waveforms with an amplitude up to 16 mA and a frequency from 1.5 Hz to 50 kHz, and a recording front-end with a programmable bandwidth of 1 Hz to 4 kHz, and a programmable amplifier gain up to 74 dB. The ASIC was implemented in a 0.18-µm CMOS technology. Simulated performance in stimulation and recording is presented.