Not in his state of mind.

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B45

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Should it be:

Talking about taking prescription drugs:

Not in his state of mind.

Not with his state of mind.
 
You'd really need a sentence to choose between those. What's it got to do with prescription drugs?
 
I would say "not in a normal state of mind".
 
I don't think your original fragment is impossible in a conversation.

- Would you recommend that he take XXX drug?
- Not in his (current) state of mind, no.
 
We speak of people being in a particular state of mind.
 
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