Which neurotransmitters does cocaine primarily increase in the synapse?

Cocaine primarily increases the levels of dopamine, norepinephrine, and epinephrine in the synapse. The mechanism of cocaine involves blocking the reuptake of these neurotransmitters, allowing them to remain in the synaptic cleft for an extended period. This results in heightened activation of the receptors for these neurotransmitters, which contributes to the stimulating effects associated with cocaine use.

Dopamine is particularly significant because it is involved in the brain's reward pathways, and its increase leads to feelings of euphoria, which reinforces drug use. Norepinephrine contributes to heightened alertness and energy levels, while epinephrine, also known as adrenaline, can lead to increased heart rate and blood pressure. The combined effect of increased levels of these neurotransmitters is what produces the intense effects of cocaine.

Other combinations mentioned in the choices either do not reflect the most critical neurotransmitters involved with cocaine or include neurotransmitters that are not as prominently affected by its use. For example, serotonin plays a role in mood regulation but is not primarily influenced by cocaine in the same capacity as the preferred answer indicates.